Kevin J Tyndall, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA168083 Issued in OR

Practice address

940 Royal Ave
Suite 420
Medford, OR 97504-6193

Phone

(541) 732-8388

Fax

(541) 732-8387

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services OregonGroup PAC ID 5294623245, 166 clinicians

PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ktyndall438660@oc.providencedirect.org
• Direct secure messaging: ktyndall651670@direct.peacehealth.org

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.

• Peacehealth

  dba Sacred Heart Physicians

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874
  Medicare reassignment Care Compare group
• Providence Health & Services Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment Care Compare group
• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287
  Medicare reassignment
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  Medicare reassignment
• Peacehealth Medical Group

  dba Nurse Midwifery Birth Center

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942
  NPD
• Providence Health & Services - Oregon

  dba PMG South OB/GYN Health Center

  • Obstetrics & Gynecology Physician
  • Medford, OR
  • NPI 1982781696
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Clinic/Center
  • Phoenix, OR
  • NPI 1992882500
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Internal Medicine Physician
  • Central Point, OR
  • NPI 1609951649
  NPD (past)

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

• Peacehealth

  dba Sacred Heart-RiverBend

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1316358393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104180",
            "telephone_number": "541-732-8388",
            "fax_number": "541-732-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 ROYAL AVE",
            "address_2": "SUITE 420",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046193",
            "telephone_number": "541-732-8388",
            "fax_number": "541-732-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALL",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA168083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500671145",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktyndall438660@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "940 Royal Ave",
            "address_2": "Suite 420",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiara Turner, LCSW
• Matthew Leroy Turpin, DPT
• Amy Twiest, LSCW
• Alicia Marie Tyler
• Terran Renee Tyler, B.S.
• Jerry Ugbo, PA-C
• Jordann And Larae Uhrig, QMHA
• Laura Marie Ulloa, MSW, LCSW
• Brennan Ullom, APRN, FNP-C
• Robyn Lynn Ultsch

• Surgical Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.