NPIMap

Individual provider Active NPI

Tyler Johnson Reinking, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1538723291
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61264179 Issued in WA
Practice address
624 E Front Ave
Spokane, WA 99202-2139
Phone
(509) 626-9900
NPI assigned
Apr 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M-17163 ID
Internal Medicine Physician 207R00000X MD61264179 WA Primary

Addresses

Primary practice location

624 E Front Ave
Spokane, WA 99202-2139

Mailing address

153 Hillside Drive BRR
Silverthorne, CO 80498
Phone (970) 389-6187

Other practice location 1

100 Hospital Dr
Suite 201
Ketchum, ID 83340
Phone (208) 727-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623001525 ID Practitioner - Internal Medicine 8820475098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Ketchum, ID 83340

100 Hospital Dr
Ketchum, ID 83340-9998

191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
91.8
Promoting interoperability
100
Improvement activities
40
Cost
61.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic - Wood River LLC Internal Medicine CurrentSince Jun 14, 2023 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1538723291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 HILLSIDE DRIVE BRR",
            "city": "SILVERTHORNE",
            "state": "CO",
            "postal_code": "80498",
            "telephone_number": "970-389-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hospital Dr",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Ketchum",
            "state": "ID",
            "postal_code": "83340",
            "country_code": "US",
            "telephone_number": "208-727-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REINKING",
        "first_name": "TYLER",
        "middle_name": "JOHNSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-17163",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61264179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.