Active NPI
Tyler Rickers, D.O.
- Psychiatry Physician
- Madison, WI
National Provider Identifier
1528017290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 50974-021
- Practice address
- 202 S Park St
Madison, WI 53715-1507 - Phone
- (608) 417-6000
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 50974-021 | WI | |
| Psychiatry Physician | 2084P0800X | 50974-021 | WI | Primary |
Addresses
Primary practice location
202 S Park St
Madison, WI 53715-1507
Mailing address
202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50974-021 | WI | MD | Hospitalist Physician |
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.
-
dba Rogers Behavioral Health
- Psychiatric Hospital
- Oconomowoc, WI
- NPI 1053329581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261008000000",
"number": "1528017290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151507",
"telephone_number": "608-417-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151507",
"telephone_number": "608-417-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKERS",
"first_name": "TYLER",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2009-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "50974-021",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "50974-021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.