Individual provider Active NPI

Tyler J D'Hulst, PA-C

  • Physician Assistant
  • Ogden, UT
National Provider Identifier
1386876530
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7437974-1206 Issued in UT
Practice address
6112 S 1550 E
Ogden, UT 84405-5007
Phone
(801) 475-3800
Fax
(801) 475-3801
NPI assigned
Aug 20, 2009
Last updated
Feb 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7437974-1206 UT Primary

Addresses

Primary practice location

6112 S 1550 E
Ogden, UT 84405-5007

Mailing address

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone (801) 475-3481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140609001303 UT Practitioner - Physician Assistant 0042434227 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1739 W Sunset Blvd
St George, UT 84770-7141
Phone (435) 634-6000

5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (866) 415-6556

577 S River Rd
St George, UT 84790-2097
Phone (435) 688-6200

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

75 N 2260
Hurricane, UT 84737-2034
Phone (435) 251-2650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 23, 2019 Accepting new patients
Midtown Community Health Center Inc CurrentSince Mar 11, 2014 Accepting new patients
Ogden Clinic Specialty Services LLC Physician Assistant Current Accepting new patients
Ihc Health Services Inc CurrentSince Sep 23, 2019 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

4088 N Highway 91
Hyde Park, UT 84318
Phone (435) 563-4888

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

201 W Layton Pkwy
Ste 1A
Layton, UT 84041
Phone (801) 543-6775

412 N 200 E
Logan, UT 84321
Phone (435) 713-2710

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

2240 Adams Ave
Ogden, UT 84401
Phone (801) 393-5355

2400 N Washington Blvd
Ogden, UT 84414
Phone (801) 387-8300

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

1915 W 5950 S
Roy, UT 84067
Phone (801) 387-8100

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

975 Chambers St
South Ogden, UT 84403
Phone (801) 387-6200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 8

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 1

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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1386876530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034303",
            "telephone_number": "801-475-3481",
            "fax_number": "801-475-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 S 1550 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844055007",
            "telephone_number": "801-475-3800",
            "fax_number": "801-475-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'HULST",
        "first_name": "TYLER",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7437974-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.