Individual provider Active NPI

Tyson K. Meyer, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Victoria, TX
National Provider Identifier
1508040361
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
M8837 Issued in TX
Practice address
605 E Locust Ave
Victoria, TX 77901-3933
Phone
(361) 572-4300
NPI assigned
Dec 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X M8837 TX Primary

Addresses

Primary practice location

605 E Locust Ave
Victoria, TX 77901-3933

Mailing address

605 E Locust Ave
Victoria, TX 77901-3933
Phone (361) 572-4300

Other identifiers 2

IdentifierTypeStateIssuer
209577001MedicaidTX
8CH237OtherTXBLUECROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091111000730 TX Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0446398432 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of South Texas, Inc CurrentSince Sep 28, 2009 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

605 E Locust Ave
Victoria, TX 77901
Phone (361) 572-4300

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of South Texas, IncVictoria, TX, CCN 451525 Hospice Contracted Managing Employee (25%)
Corporate Director (5%)
Sep 4, 2019
Sep 4, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1508040361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E LOCUST AVE",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013933",
            "telephone_number": "361-572-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E LOCUST AVE",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013933",
            "telephone_number": "361-572-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "TYSON",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "M8837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209577001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "8CH237",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.