Individual provider Active NPI

Tyler K Hartman, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Lebanon, NH
National Provider Identifier
1457451643
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
15794 Issued in NH
Practice address
1 Medical Center Dr
DHMC - Dept of Neonatology
Lebanon, NH 03756-1000
Phone
(603) 653-6070
Fax
(603) 653-3585
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 48909 MN
Neonatal-Perinatal Medicine Physician 2080N0001X 15794 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
DHMC - Dept of Neonatology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC - Dept of Neonatology
Lebanon, NH 03756-1000
Phone (603) 653-6070

Other identifiers 1

IdentifierTypeStateIssuer
876657100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121210000420 NH Practitioner - Pediatric MedicinePractitioner - Other (Physician) 1254338130 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48909MNMDPediatrics Physician
15794NHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Health Services Pediatrics CurrentSince Jan 21, 2013 Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Jan 21, 2013 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 2, 2017 Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Oct 2, 2012 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

5 Washington Pl
Bedford, NH 03110
Phone (603) 314-4567

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229

Interoperability endpoints

  • Direct secure messaging: thartman98993@direct.dartmouth-hitchcock.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1457451643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - DEPT OF NEONATOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - DEPT OF NEONATOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6070",
            "fax_number": "603-653-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "TYLER",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "48909",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NH",
            "license": "15794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876657100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.