Samuel J Tyriver, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14498 Issued in WI

Practice address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Phone

(414) 266-2858

Fax

(414) 266-1697

NPI assigned

Jul 16, 2012

Last updated

Oct 19, 2020By the provider in NPPES

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 WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Orthopedic Specialty Hospital, LLCGroup PAC ID 7113078833, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Midwest Orthopedic Specialty Hospital, LLC

  • Orthopaedic Surgery Physician
  • Franklin, WI
  • NPI 1275127375
  Medicare reassignment Care Compare group NPD
• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  WI

  Medicare reassignment NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Rehabilitation Clinic/Center
  • Oak Creek, WI
  • NPI 1811635949
  NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Durable Medical Equipment & Medical Supplies
  • Muskego, WI
  • NPI 1962238113
  NPD
• Pioneer Pet, LLC

  • Diagnostic Radiology Physician
  • Tempe, AZ
  • NPI 1265401996
  NPD (past)
• Solace Pediatric Healthcare Therapy Services Az, Inc.

  dba Care Options For Kids

  • Physical Therapist
  • Tempe, AZ
  • NPI 1669533105
  NPD (past)

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1487909438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2858",
            "fax_number": "414-266-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRIVER",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Suzanne Tyley, CAA
• Mary Aschbacher Tylicki, OTR/L
• Mary Tylke, PHARMD
• Brandon Tyra
• Terrence Robert Tyree, SAC
• Desziree Tyson
• Julian Tyte
• U.S. Department of Veterans Affairs
• U.S. Healthworks Medical Group of Wisconsin, SC
• U.S. Healthworks Medical Group of Wisconsin, SC

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.