Tyler Wilson Clemmensen

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

35415 Issued in AL

Practice address

625 19TH St S
Birmingham, AL 35249

Phone

(205) 934-4303

Fax

(205) 934-5499

NPI assigned

Apr 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of Tennessee, HSC, College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pathology Associates of AlabamaGroup PAC ID 0941293864, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grandview Medical Center Hospital, Birmingham, AL, CCN 010104
• Princeton Baptist Medical Center Hospital, Birmingham, AL, CCN 010103
• Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089
• University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

Merit-based Incentive Payment System (MIPS)

Final score

76.3 of 100Reported as group

Quality

50

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pathology Associates of Alabama

  • Anatomic Pathology & Clinical Pathology Physician
  • Birmingham, AL
  • NPI 1396815536
  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates of North-Central Alabama Inc

  • Specialist
  • Birmingham, AL
  • NPI 1528080595
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Gastroenterology Associates of North-Central Alabama Inc

  • Anesthesiology Physician
  • Birmingham, AL
  • NPI 1912446105
  NPD

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

• Affinity Hospital LLC

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  Care Compare affiliation
• BBH PBMC, LLC

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1164876546
  Care Compare affiliation
• BBH WBMC, LLC

  • General Acute Care Hospital
  • Jasper, AL
  • NPI 1932553385
  Care Compare affiliation
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1154435824
  Care Compare affiliation
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  Care Compare affiliation

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1265852107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35249",
            "telephone_number": "205-934-4303",
            "fax_number": "205-934-5499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352491900",
            "country_code": "US",
            "telephone_number": "205-934-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMMENSEN",
        "first_name": "TYLER",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AL",
            "license": "35415",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AL",
            "license": "35415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Austin Clements, DO
• David Marcus Clements, M.D.
• Ernestine Clements
• Kristi Lynn Clements, PH.D.
• Natalie Franklin Clements, RDN,LD
• Sheena Marie Clemons, RN
• Kedrick Lamar Clepper
• Clifford Wayne Cleveland III
• Emma Ruth Cleveland
• Joseph Cleveland, RN

• Anatomic Pathology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Anatomic Pathology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.