Individual provider Active NPI

Tyler David Stutzman, MD

  • Diagnostic Radiology Physician
  • Greensboro, NC
National Provider Identifier
1295220507
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2023-00173 Issued in NC
Practice address
1331 N Elm St Ste 200
Greensboro, NC 27401-6304
Phone
(336) 274-6682
Fax
(336) 274-8097
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2023-00173 NC Primary

Addresses

Primary practice location

1331 N Elm St Ste 200
Greensboro, NC 27401-6304

Mailing address

PO Box 85378
Chicago, IL 60689-5378
Phone (336) 274-6682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20230302001182 NC Practitioner - Diagnostic Radiology 0749518413 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Radiology and Imaging LLCGroup PAC ID 4183517097, 87 clinicians
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiology & Imaging LLC Diagnostic Radiology CurrentSince Dec 30, 2022 Accepting new patients
Pinnacle Health Services of North Carolina LLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Jan 31, 2023 Accepting new patients
Imrad of Virginia PLLC Diagnostic Radiology CurrentSince Dec 6, 2022 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Diagnostic Radiology & Imaging, LLC Diagnostic Radiology Past Accepting new patients

Locations

4030 Oaks Professional Pkwy
Ste 101
Burlington, NC 27215

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

1002 N Church St
Ste 401
Greensboro, NC 27401
Phone (336) 271-4999

1126 N Church St
Ste 200
Greensboro, NC 27401
Phone (336) 379-0941

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

315 W Wendover Ave
Greensboro, NC 27408
Phone (336) 273-0530

Organizations & group practices 6

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 5

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1295220507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85378",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895378",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016304",
            "telephone_number": "336-274-6682",
            "fax_number": "336-274-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2023-00173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.