Kevin Tyler, DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

17519 Issued in ND

Practice address

1200 S. Columbia Rd
Grand Forks, ND 58201

Phone

(701) 780-6000

NPI assigned

Aug 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Pathology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019
• Lifecare Medical Center Hospital, Roseau, MN, CCN 241344
• Unity Medical Center Hospital, Grafton, ND, CCN 351320
• Northwood Deaconess Health Center Hospital, Northwood, ND, CCN 351312
• North Valley Health Center Hospital, Warren, MN, CCN 241337

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation
• Christian Unity Hospital Corporation

  • Critical Access Hospital
  • Grafton, ND
  • NPI 1245216852
  Care Compare affiliation
• Northwood Deaconess Health Center

  • Critical Access Hospital
  • Northwood, ND
  • NPI 1356449136
  Care Compare affiliation
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Care Compare affiliation
• Warren Community Hospital, Inc.

  • Critical Access Hospital
  • Warren, MN
  • NPI 1073516357
  Care Compare affiliation

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1366634370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S. COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "53208-021",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "48679",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "OS015591",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ND",
            "license": "17519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Marie Tupa, LSW
• Shelby Turck, SLP
• Alyssa Turner-Strong, MS, OTR/L
• Leeann Marie Tweten, CNA
• John D. Tyler
• Shirley K. Tyler, PH.D.
• Elizabeth Ann Tyree, RN, PNP
• Austen Tyryfter
• Spencer Dane Uetz, MD
• Matthew James Uhrich, RPH

• Anatomic Pathology & Clinical Pathology Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.

Verify at the official NPI Registry.