NPIMap

Individual provider Active NPI

Tyson Nielsen, MD

  • Otolaryngology Physician
  • Boise, ID
National Provider Identifier
1326435249
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
M-15604 Issued in ID
Practice address
900 N Liberty St Ste 400
Boise, ID 83704-8707
Phone
(208) 367-3320
Fax
(208) 267-3979
NPI assigned
Apr 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X M-15604 ID Primary

Addresses

Primary practice location

900 N Liberty St Ste 400
Boise, ID 83704-8707

Mailing address

900 N Liberty St Ste 400
Boise, ID 83704-8707
Phone (208) 367-3320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210618001913 ID Practitioner - Otolaryngology 7012272842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Washington School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Idaho Ear Nose and ThroatGroup PAC ID 0042402034, 16 clinicians

Practice addresses (Care Compare)

900 N Liberty St
Suite 400
Boise, ID 83704-8707
Phone (208) 336-4368

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Elmore Medical Center Hospital, Mountain Home, ID, CCN 131311

Merit-based Incentive Payment System (MIPS)

Final score
75.94 of 100Reported as group
Quality
63.68
Improvement activities
40
Cost
68.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision15
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-15604IDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Idaho Ear, Nose and Throat Otolaryngology CurrentSince Aug 1, 2021 Accepting new patients

Locations

900 N Liberty St
Ste 400
Boise, ID 83704
Phone (208) 336-4368

900 N Liberty St
Boise, ID 83704
Phone (208) 367-2229

900 N Liberty St
Ste 450
Boise, ID 83704
Phone (208) 367-7431

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAGCD

Organizations & group practices 1

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.

Hospital & facility affiliations 11

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1326435249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-367-3320",
            "fax_number": "208-367-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-367-3320",
            "fax_number": "208-267-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "TYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ID",
            "license": "M-15604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.