NPIMap

Individual provider Active NPI

Tyler J Harris, MD

  • Diagnostic Radiology Physician
  • Boise, ID
National Provider Identifier
1275794935
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M12086 Issued in ID
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-2094
Fax
(208) 381-1791
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M12086 ID Primary
Diagnostic Radiology Physician 2085R0202X A119515 CA

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

PO Box 1108
Corvallis, OR 97339-1108
Phone (208) 381-2094

Other identifiers 1

IdentifierTypeStateIssuer
0A1195150MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120614000711 CA Practitioner - Interventional Radiology 6305000787 Reassigns benefits to 1 organization
I20130710000749 ID Practitioner - Diagnostic Radiology 6305000787 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians
Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 549-0370

3277 E Louise Dr
Suite 150
Meridian, ID 83642-9373
Phone (208) 706-8346

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
92.87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-12361IDMDEmergency Medicine Physician
M12086IDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Weiser Valley Hospital District CurrentSince Jul 20, 2013 Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Weiser Valley Hospital District Diagnostic Radiology CurrentSince Jul 20, 2013 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Apr 1, 2016 Accepting new patients
Boise Radiology Group PLLC Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology CurrentSince Jun 1, 2012 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

703 S Americana Blvd
Boise, ID 83702
Phone (208) 706-6375

115 W Main St
Ste 202
Boise, ID 83702
Phone (208) 433-9466

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

1000 E Park Blvd
Boise, ID 83712
Phone (208) 381-4100

600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444

3101 E State St
Eagle, ID 83616
Phone (208) 473-3100

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

3277 E Louise Dr
Ste 150
Meridian, ID 83642
Phone (208) 388-7239

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

Interoperability endpoints

  • Direct secure messaging: tharris23111@direct.slhs.org

Organizations & group practices 10

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

Hospital & facility affiliations 11

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1275794935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391108",
            "telephone_number": "208-381-2094",
            "fax_number": "208-381-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2094",
            "fax_number": "208-381-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TYLER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M12086",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A119515",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1195150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.