Individual provider Active NPI

Tyler Richard Scott, D.O.

  • Neurology Physician
  • Medford, OR
National Provider Identifier
1366897365
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DO219654 Issued in OR
Practice address
2900 State St Ste 101
Medford, OR 97504-8458
Phone
(541) 789-5790
Fax
(541) 789-5973
NPI assigned
Apr 27, 2016
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DO219654 OR Primary

Addresses

Primary practice location

2900 State St Ste 101
Medford, OR 97504-8458

Mailing address

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (724) 809-6077

Other practice location 1

520 SW Ramsey Ave Ste 201
Grants Pass, OR 97527-5535
Phone (541) 789-5790

Other identifiers 1

IdentifierTypeStateIssuer
15144730OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210525000127 PA Practitioner - Neurology 4082902697 Reassigns benefits to 1 organization
I20240524003479 OR Practitioner - Neurology 4082902697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

2900 State St
Suite 101
Medford, OR 97504-8475
Phone (541) 789-5790

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Jul 1, 2021 Accepting new patients
Allegheny Clinic CurrentSince Jul 1, 2021 Accepting new patients
Asante Physician Partners CurrentSince Jun 1, 2024 Accepting new patients
Hematology Oncology Associates, P.C. PastSince Feb 15, 2016 Accepting new patients
Allegheny Clinic Neurology Past Accepting new patients
App Neurology Clinic PastSince Jun 1, 2024 Accepting new patients

Locations

520 SW Ramsey Ave
Ste 201
Grants Pass, OR 97527
Phone (541) 774-5853

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2900 State St
Ste 101
Medford, OR 97504
Phone (541) 789-5790

520 Medical Center Dr
Ste 201
Medford, OR 97504
Phone (541) 789-5710

575 Coal Valley Rd
Ste 464
Jefferson Hills, PA 15025
Phone (412) 267-6360

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1366897365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "724-809-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 STATE ST STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048458",
            "telephone_number": "541-789-5790",
            "fax_number": "541-789-5973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 SW Ramsey Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275535",
            "country_code": "US",
            "telephone_number": "541-789-5790",
            "fax_number": "541-789-5973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "TYLER",
        "middle_name": "RICHARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "DO219654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15144730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.