NPIMap

Individual provider Active NPI

Tyler Aspinwall Clark, M.D.

  • Neurology Physician
  • Bend, OR
National Provider Identifier
1447549183
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD171002 Issued in OR
Practice address
2349 NE Conners Ave
Bend, OR 97701
Phone
(541) 317-0044
Fax
(541) 728-0707
NPI assigned
Apr 4, 2011
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD60737259 WA
Neurology Physician 2084N0400X MD171002 OR Primary

Addresses

Primary practice location

2349 NE Conners Ave
Bend, OR 97701

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 339-5408

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Other practice location 2

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5408

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521000853 OR Practitioner - Neurology 0749435550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bend Neurological Associates LLCGroup PAC ID 6800085952, 5 clinicians

Practice addresses (Care Compare)

2349 NE Conners Ave
Bend, OR 97701-6068
Phone (541) 317-0044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.15 of 100Reported as group
Quality
84.07
Improvement activities
40
Cost
68.41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Neurological Associates LLC Neurology CurrentSince Jul 1, 2021 Accepting new patients

Locations

2349 NE Conners Ave
Bend, OR 97701
Phone (541) 317-0044

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1447549183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-339-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 NE CONNERS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-317-0044",
            "fax_number": "541-728-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014918",
            "country_code": "US",
            "telephone_number": "425-339-5408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TYLER",
        "middle_name": "ASPINWALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60737259",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD171002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.