NPIMap

Individual provider Active NPI

Ryan E Tyler, M.D.

  • Family Medicine Physician
  • Watertown, NY
National Provider Identifier
1336198639
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
224807 Issued in NY
Practice address
1575 Washington St
Watertown, NY 13601-9367
Phone
(315) 786-7300
Fax
(315) 786-7310
NPI assigned
May 6, 2006
Last updated
May 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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 224807 NY Primary

Addresses

Primary practice location

1575 Washington St
Watertown, NY 13601-9367

Mailing address

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 786-7300

Other identifiers 1

IdentifierTypeStateIssuer
00354316MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100107000619 NY Practitioner - Family Practice 1153462577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 779-5060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224807NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ryan.tyler@sfhcny.eclinicaldirectplus.com

Organizations & group practices 2

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 8

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1336198639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019367",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "RYAN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.