NPIMap

Individual provider Active NPI

Tyler J Bailey, MD

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1447480256
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
55820 Issued in WI
Practice address
2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone
(920) 336-4096
Fax
(920) 336-8093
NPI assigned
Jul 15, 2009
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 55820 WI Primary
Vascular & Interventional Radiology Physician 2085R0204X 55820 WI

Addresses

Primary practice location

2941 S Ridge Rd
Green Bay, WI 54304-5517

Mailing address

2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone (920) 336-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110810000648 WI Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5395914204 Reassigns benefits to 6 organizations
I20231116003303 MN Practitioner - Diagnostic Radiology 5395914204 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians
Green Bay Radiology SCGroup PAC ID 7113908310, 24 clinicians
GBR Sheboygan LLCGroup PAC ID 1951341064, 22 clinicians
Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians
Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

101 School Creek TRL
Luxemburg, WI 54217-1095
Phone (920) 496-4700

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

1300 E Green Bay St
Shawano, WI 54166-2210
Phone (920) 496-4700

1411 N Taylor Dr
Sheboygan, WI 53081-3043
Phone (920) 457-4858

15 S 10TH St
Suite a
Oostburg, WI 53070-1370
Phone (920) 552-5046

1686 Eisenhower Rd
De Pere, WI 54115-8145
Phone (920) 496-4700

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 496-4700

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

1860 Shawano Ave
Green Bay, WI 54303-2667
Phone (920) 496-4700

2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone (920) 496-4700

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (800) 472-6710

3113 Saemann Ave
Sheboygan, WI 53081-1957
Phone (920) 496-4700

3750 Investors CT
Grand Chute, WI 54913-2330
Phone (920) 496-4700

3860 Monroe Rd
De Pere, WI 54115-8399
Phone (920) 496-4700

700 Osceola Ave
Saint Paul, MN 55105-3515
Phone (614) 340-7740

700 Oseceola Ave
St. Paul, WI 55105
Phone (614) 340-7740

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 496-4700

950 Woodlake Rd
Kohler, WI 53044-1348
Phone (920) 783-3150

PO Box
Suite 19070
Green Bay, WI 54307-9070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55820WIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince May 16, 2024 Accepting new patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2011 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2011 Accepting new patients
Dean Health Systems, Inc. CurrentSince May 16, 2024 Accepting new patients
Green Bay Radiology SC Diagnostic Radiology CurrentSince Aug 1, 2011 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Aug 1, 2011 Accepting new patients
GBR Sheboygan LLC Diagnostic Radiology CurrentSince Aug 1, 2011 Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Nov 1, 2023 Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Oct 14, 2023 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Aug 1, 2011 Accepting new patients
Madison Radiologists S C Diagnostic Radiology CurrentSince Oct 21, 2024 Accepting new patients

Locations

9630 Grove Cir N
Ste 100
Maple Grove, MN 55369
Phone (763) 416-9916

100 E Campus View Blvd
Ste 100
Columbus, OH 43235
Phone (313) 745-3430

2941 S Ridge Rd
Green Bay, WI 54304
Phone (920) 336-4096

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 12

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1447480256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "TYLER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "55820",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "55820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.