NPIMap

Individual provider Active NPI

Tyson A. Hadduck, M.D.

  • Vascular & Interventional Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1336409382
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A127728 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone
(310) 301-6800
NPI assigned
May 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A127728 CA
Vascular & Interventional Radiology Physician 2085R0204X A127728 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90095-5631
Phone (310) 267-8796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20180425002124 CO Practitioner - Interventional Radiology 5193094688 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Baylor College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, 146 clinicians
Radiology and Imaging Consultants PCGroup PAC ID 1850298647, 45 clinicians
Uchealth Imaging Services LLCGroup PAC ID 5799021291, 247 clinicians

Practice addresses (Care Compare)

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-2511

175 S Union Blvd
Colorado Springs, CO 80910-3113
Phone (719) 365-5242

5818 N Nevada Ave
Suite 100
Colorado Springs, CO 80918-3505
Phone (719) 365-7480

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326
  • San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130
  • San Luis Valley Health Conejos County Hospital Hospital, La Jara, CO, CCN 061308

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
100
Improvement activities
40
Cost
43.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127728CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uchealth Imaging Services LLC CurrentSince Dec 14, 2020 Accepting new patients
Radiology & Imaging Consultants PC Diagnostic Radiology CurrentSince May 1, 2018 Accepting new patients
Lutheran Hospital Association of the San Luis Valley CurrentSince Aug 1, 2025 Accepting new patients
Lutheran Hospital Association of the San Luis Valley CurrentSince Aug 1, 2025 Accepting new patients
Uchealth Imaging Services, LLC Diagnostic Radiology Current Accepting new patients
Uchealth Imaging Services, LLC Diagnostic Radiology CurrentSince Dec 14, 2020 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511

875 W 136th Ave
Ste 100
Broomfield, CO 80023
Phone (303) 457-7700

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

1370 Interquest Pkwy
Ste 110
Colorado Springs, CO 80921
Phone (719) 364-6600

1370 Interquest Pkwy
Ste 100
Colorado Springs, CO 80921

175 S Union Blvd
Colorado Springs, CO 80910
Phone (719) 305-8000

3843 Rio Vista Dr
Ste 1100
Colorado Springs, CO 80917
Phone (719) 364-4903

310 County Road 14
Del Norte, CO 81132
Phone (719) 657-2510

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

19021 US Highway 285
La Jara, CO 81140
Phone (719) 274-5121

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 and National Provider Directory roles.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336409382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955631",
            "telephone_number": "310-267-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-301-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDUCK",
        "first_name": "TYSON",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A127728",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A127728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.