NPIMap

Individual provider Active NPI

Tyler Jay Thorson, MD

  • Family Medicine Physician
  • Polson, MT
National Provider Identifier
1548647290
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68391 Issued in MT
Practice address
104 Rufus LN
Polson, MT 59860
Phone
(406) 883-2555
Fax
(406) 883-2559
NPI assigned
May 1, 2015
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 68391 MT Primary

Addresses

Primary practice location

104 Rufus LN
Polson, MT 59860

Mailing address

104 Rufus LN
Polson, MT 59860-8903
Phone (406) 883-2555

Other practice location 1

310 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 751-5310

Other practice location 2

1600 Hospital Way
Whitefish, MT 59937-7849
Phone (406) 863-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Krmcmedicalrecords@krhdirect.org Direct Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20181214002525 MT Practitioner - General Practice 4284979543 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1035 1St Ave W
Kalispell, MT 59901-5607
Phone (406) 607-4900

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-5310

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68391MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Aug 12, 2024 Accepting new patients
St Lukes Community Hospital CurrentSince Sep 8, 2018 Accepting new patients
Flathead Community Health Center, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Flathead Community Health Center, Inc. CurrentSince Aug 1, 2021 Accepting new patients
St. Lukes Community Hospital Family Medicine Current Accepting new patients
St Lukes Community Hospital Current Accepting new patients
St Lukes Community Hospital CurrentSince Sep 8, 2018 Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Aug 12, 2024 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients
Kalispell Regional Medical Center Inc Past Accepting new patients

Locations

1035 1st Ave W
Kalispell, MT 59901
Phone (406) 751-8105

1035 1st Ave W
Ste 210
Kalispell, MT 59901
Phone (406) 607-4900

124 3rd Ave E
Kalispell, MT 59901
Phone (406) 607-4900

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

104 Rufus Ln
Polson, MT 59860
Phone (406) 543-8512

107 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

126 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

1600 Hospital Way
Whitefish, MT 59937
Phone (406) 863-3500

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1548647290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 RUFUS LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608903",
            "telephone_number": "406-883-2555",
            "fax_number": "406-883-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 RUFUS LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "59860",
            "telephone_number": "406-883-2555",
            "fax_number": "406-883-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-751-5310",
            "fax_number": "406-751-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Hospital Way",
            "address_purpose": "LOCATION",
            "city": "Whitefish",
            "state": "MT",
            "postal_code": "599377849",
            "country_code": "US",
            "telephone_number": "406-863-3500",
            "fax_number": "406-607-4580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORSON",
        "first_name": "TYLER",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-01",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "68391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.