Individual provider Active NPI

Tyler Keith Yocum, PA-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1265055388
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9410 Issued in AZ
Practice address
5301 E Grant Rd
Tucson, AZ 85712-2805
Phone
(520) 784-6200
Fax
(520) 784-6109
NPI assigned
May 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 9410 AZ
Surgical Physician Assistant 363AS0400X 9410 AZ
Physician Assistant 363A00000X 9410 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Tucson, AZ 85712-2805

Mailing address

PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 784-6200

Other names 1

  • Ty Keith Yocum Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221111001895 AZ Practitioner - Physician Assistant 5193192615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tucson Orthopaedic Institute Professional CorporationGroup PAC ID 5799671905, 108 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 784-6200

6320 N la Cholla Blvd
Suite 200
Tucson, AZ 85741-3549
Phone (520) 382-8200

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9410AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Nov 14, 2022 Accepting new patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant CurrentSince Aug 12, 2024 Accepting new patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant CurrentSince Aug 12, 2024 Accepting new patients

Locations

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

5301 E Grant Rd
Bldg 1
Tucson, AZ 85712

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

6320 N La Cholla Blvd
Ste 200
Tucson, AZ 85741

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

10350 E Drexel Rd
Ste 210
Tucson, AZ 85747
Phone (520) 625-6600

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1265055388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCUM",
        "first_name": "TYLER",
        "middle_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "9410",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9410",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TY",
            "last_name": "YOCUM",
            "middle_name": "KEITH",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.