Tyler Hepworth, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-907 Issued in ID

Practice address

777 Hospital Way
Pocatello, ID 83201-5175

Phone

(480) 421-9700

Fax

(480) 421-9899

NPI assigned

Apr 26, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Hospital LLC 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362

  ID

  Medicare reassignment Care Compare group NPD
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)
• Pebble Creek Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Pocatello, ID
  • NPI 1386019784
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114

  Hospital

  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1447541487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15070",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852675070",
            "telephone_number": "480-421-9700",
            "fax_number": "480-421-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "480-421-9700",
            "fax_number": "480-421-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPWORTH",
        "first_name": "TYLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Henderson, CPT
• Ryan Hendricks, DPT
• Savannah J Hendricks
• Thomas Henrie, AT
• Kimberly Heppner
• Judy Herald-Bowden, BS
• Heritage Home Health LLC
• Heritage Home Health, LLC
• Heritage Physician and Resource Group LLC
• Daniel Herrera, B.A. R.C.

• All providers in Pocatello, ID
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.