Individual provider Active NPI

Tyler David Reamsnyder, MD

  • Family Medicine Physician
  • Granger, IN
National Provider Identifier
1316407794
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01088457A Issued in IN
Practice address
12563 State Road 23
Granger, IN 46530-9226
Phone
(574) 335-8300
Fax
(574) 335-0775
NPI assigned
Mar 22, 2019
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01088457A IN Primary

Addresses

Primary practice location

12563 State Road 23
Granger, IN 46530-9226

Mailing address

707 Cedar St Ste 405
South Bend, IN 46617-2059

Other identifiers 2

IdentifierTypeStateIssuer
1102631494OtherINANTHEM
300027868MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220829001690 IN Practitioner - Family Practice 1850624230 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

12563 State Rd
Suite 23
Granger, IN 46530-9226
Phone (574) 335-8300

401 S Broad St
Suite D
Fremont, IN 46737-2114
Phone (260) 667-5685

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088457AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Feb 9, 2026 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Medicine CurrentSince Sep 5, 2022 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc CurrentSince Sep 5, 2022 Accepting new patients
Cameron Memorial Community Hospital, Inc Family Medicine CurrentSince Feb 9, 2026 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Sep 5, 2022 Accepting new patients

Locations

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

12563 State Road 23
Granger, IN 46530
Phone (574) 277-2090

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 407
Mishawaka, IN 46545
Phone (574) 335-6500

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

707 Cedar St
Ste 405
South Bend, IN 46617
Phone (574) 237-7878

Interoperability endpoints

  • Direct secure messaging: treamsnyder1147622@direct.trinity-health.org

Organizations & group practices 7

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 6

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1316407794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12563 STATE ROAD 23",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309226",
            "telephone_number": "574-335-8300",
            "fax_number": "574-335-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAMSNYDER",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01088457A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102631494",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300027868",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.