Individual provider Active NPI

Tyler F Brockman, D.O.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1407397730
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2028 Issued in NE
Practice address
16120 W Dodge Rd
Omaha, NE 68118-2049
Phone
(402) 354-0610
Fax
(402) 354-0649
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2028 NE Primary
Family Medicine Physician 207Q00000X E-13314 AR
Student in an Organized Health Care Education/Training Program 390200000X NE

Addresses

Primary practice location

16120 W Dodge Rd
Omaha, NE 68118-2049

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other practice location 1

4200 Douglas St
Omaha, NE 68131-2705
Phone (402) 552-3222

Other practice location 2

3 E. Appleby Rd
Suite 301
Fayetteville, AR 72703
Phone (479) 404-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, AR2 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
I20200227000129 NE Practitioner - Family Practice 7012280183
I20200805002478 AR Practitioner - Family Practice 7012280183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, shared by 5 NPIs, 557 clinicians

Practice addresses (Care Compare)

16120 W Dodge Rd
Omaha, NE 68118-2049
Phone (402) 354-0550

3 E Appleby Rd
Suite 301
Fayetteville, AR 72703-3160
Phone (479) 463-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2028NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Washington Regional Medical System Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Nebraska Medical Center Family Medicine Past Accepting new patients
The Nebraska Medical Center Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

3 E Appleby Rd
Ste 301
Fayetteville, AR 72703
Phone (479) 404-1200

Interoperability endpoints

  • Direct secure messaging: tylerbrockman@wrms.allscriptsdirect.net
  • Direct secure messaging: tbrockman21982@washingtonregional.direct-ci.com

Organizations & group practices 5

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 2

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1407397730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16120 W DODGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182049",
            "telephone_number": "402-354-0610",
            "fax_number": "402-354-0649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Douglas St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681312705",
            "country_code": "US",
            "telephone_number": "402-552-3222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 E. Appleby Rd",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "72703",
            "country_code": "US",
            "telephone_number": "479-404-1200",
            "fax_number": "479-404-1201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "TYLER",
        "middle_name": "F",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "2028",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-13314",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.