Individual provider Active NPI

Tyler Paul Kearney, D.P.M

  • Podiatrist
  • College Station, TX
National Provider Identifier
1376788752
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1979 Issued in TX
Practice address
3312 Longmire Dr
College Station, TX 77845-5812
Phone
(979) 776-6060
Fax
(979) 776-6172
NPI assigned
Dec 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X T33-2008 TX
Podiatrist 213E00000X 1979 TX Primary

Addresses

Primary practice location

3312 Longmire Dr
College Station, TX 77845-5812

Mailing address

3312 Longmire Dr
College Station, TX 77845-5812
Phone (979) 776-6060

Other identifiers 2

IdentifierTypeStateIssuer
080873501MedicaidTX
P01002151OtherTXRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000399 TX Practitioner - Podiatry 3678746245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brazos Valley Foot Care PAGroup PAC ID 8224130257, 6 clinicians

Practice addresses (Care Compare)

3312 Longmire Dr
College Station, TX 77845-5812
Phone (979) 776-6060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.47 of 100Reported as group
Quality
90
Improvement activities
40
Cost
71.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue133
Removal of skin lesions1-10
Removal of nail tissue552
Removal or shaving of skin growth143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1979TXMDPodiatrist
T33-2008TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Foot Care PA Podiatrist CurrentSince Aug 11, 2011 Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

103 W Highway 21
Caldwell, TX 77836

2104 N Karnes Ave
Cameron, TX 76520
Phone (254) 697-4985

3312 Longmire Dr
College Station, TX 77845
Phone (979) 314-4614

625 McClintic Dr
Groesbeck, TX 76642
Phone (254) 399-0741

701 McClintic Dr
Lake Limestone, TX 76642
Phone (254) 729-3281

514 S Bonham St
Ste D
Mexia, TX 76667
Phone (254) 562-5961

514 S Bonham St
Mexia, TX 76667
Phone (254) 562-9321

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 4

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": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1376788752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 LONGMIRE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455812",
            "telephone_number": "979-776-6060",
            "fax_number": "979-776-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 LONGMIRE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455812",
            "telephone_number": "979-776-6060",
            "fax_number": "979-776-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "TYLER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-12",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "T33-2008",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080873501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01002151",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.