Active NPI
Tyler Ryan McKinnish, MD
- Gynecologic Oncology Physician
- Scarborough, ME
National Provider Identifier
1316430010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- MD29474
- Practice address
- 100 Campus Dr Unit 125
Scarborough, ME 04074-7171 - Phone
- (207) 883-0069
- Fax
- (207) 883-0999
- NPI assigned
- Jun 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD29474 | ME | |
| Gynecologic Oncology Physician | 207VX0201X | MD29474 | ME | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 2018017675 | MO |
Addresses
Primary practice location
100 Campus Dr Unit 125
Scarborough, ME 04074-7171
Mailing address
100 Campus Dr Unit 125
Scarborough, ME 04074-7171
Phone (207) 883-0069
Other practice location 1
1 Barnes Jew Hosp Plz
Saint Louis, MO 63110-1003
Phone (314) 362-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gynecological Oncology
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Campus Dr
Unit 125
Scarborough, ME 04074-7171
Phone (207) 883-0069
100 US Route 1
MMC Scarborough Campus
Scarborough, ME 04074-7171
Phone (207) 885-7500
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
- Mainehealth Maine Medical Center
- Northern Light Eastern Maine Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018017675 | MO | MD | Obstetrics & Gynecology Physician |
| MD29474 | ME | MD | Gynecologic Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Obstetrics & Gynecology | Current | Accepting new patients |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
100 Campus Dr
Unit 125
Scarborough, ME 04074
Phone (207) 883-0069
1 Riverfront Plz
Westbrook, ME 04092
Phone (207) 885-9905
Interoperability endpoints
- tmckinnish923320@direct.mmc.mainehealth.org
Organizations & group practices 4
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Clinic/Center
- Portland, ME
- NPI 1487346722
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1790789147
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1316430010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CAMPUS DR UNIT 125",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040747171",
"telephone_number": "207-883-0069",
"fax_number": "207-883-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CAMPUS DR UNIT 125",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040747171",
"telephone_number": "207-883-0069",
"fax_number": "207-883-0999"
}
],
"practiceLocations": [
{
"address_1": "1 Barnes Jew Hosp Plz",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101003",
"country_code": "US",
"telephone_number": "314-362-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKINNISH",
"first_name": "TYLER",
"middle_name": "RYAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "ME",
"license": "MD29474",
"primary": false
},
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "ME",
"license": "MD29474",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "2018017675",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.