Tyler Humphrey, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301504433 Issued in MI

Practice address

4440 W 95TH St
Oak Lawn, IL 60453-2600

Phone

(708) 684-5375

NPI assigned

May 25, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MI2 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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thumphrey2@direct.mhc.net

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.

• Caberfae Emergency Group, P.C.

  • Emergency Medicine Physician
  • Cadillac, MI
  • NPI 1447932504
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Hawk Emergency Group, P.C.

  • Emergency Medicine Physician
  • Charlevoix, MI
  • NPI 1073295135
  Medicare reassignment NPD
• Kalkaska Memorial Health Center

  • Family Medicine Physician
  • Kalkaska, MI
  • NPI 1013183060

  Emergency Medicine

  Medicare reassignment NPD
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Auburn, CA
  • NPI 1700184819
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Kalkaska Memorial Health Center

  • Skilled Nursing Facility
  • Kalkaska, MI
  • NPI 1164386652
  NPD
• Kalkaska Memorial Health Center

  • Rural Health Clinic/Center
  • Kalkaska, MI
  • NPI 1306968102
  NPD
• Munson Medical Center

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1508390741
  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1467980102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7506",
            "fax_number": "231-258-7592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125070440",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036152059",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301504433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie A Hughes, NP
• Darlene Huisenga, PT, PCS
• Sarah Ruth Huisenga, DO
• Jade Denae Huizenga, PHARMD, B.S., B.A.
• Michael Huley, RSA
• Kiana Marie Hunter
• Janae Hunziker, M.S.W.
• David Martin Hurley, L.C.P.C.
• Meghan Maureen Hurley, MD
• Tarek Husayni, MD

• Emergency Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.