Tyler Pickle, LCSW, CADC-I

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10375 Issued in OR

Practice address

11035 NE Sandy Blvd
Portland, OR 97220-2553

Phone

(503) 735-6603

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oregon Health and Science UniversityGroup PAC ID 1759328842, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Oregon Health & Science University

  • Rural Health Clinic/Center
  • Scappoose, OR
  • NPI 1417969304
  Medicare reassignment Care Compare group NPD
• Oregon Health & Science University

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1457129678
  NPD
• Oregon Health & Science University

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1487902706
  NPD

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1285070839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021643",
            "telephone_number": "503-418-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11035 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202553",
            "telephone_number": "503-735-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKLE",
        "first_name": "TYLER",
        "credential": "LCSW, CADC-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna M Pickering, MD
• Ronnie Lee Pickering, PHARM.D.
• Tisa Pickering, MSW
• Mary Ellis Pickett, MD
• Barbara Ann Pickle, LMT
• Aaron Anthony Pickrell, M.D.
• Shaylie Lucille Pickrell
• Courtney Kathleen Pickworth, ND
• Madison Grace Pico, MD
• Elizabeth Ann Picologlou, MD

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.