Individual provider Active NPI

Richard James Tyler Jr., M.D.

  • Pediatrics Physician
  • Woonsocket, RI
National Provider Identifier
1578910147
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD17120 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
NPI assigned
May 24, 2016
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 300226 NY
Pediatrics Physician 208000000X MD17120 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other practice location 1

4811 Buckley Rd
Liverpool, NY 13088-3676
Phone (518) 488-8193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20210811003379 RI Practitioner - Pediatric Medicine 7416293337 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300226NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Apr 10, 2021 Accepting new patients
Thundermist Health Center CurrentSince Apr 10, 2021 Accepting new patients
Thundermist Health Center Current Accepting new patients

Locations

191 Social St
Woonsocket, RI 02895
Phone (401) 597-6500

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA
  • Direct secure messaging: richard.tyler@thundermist.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1578910147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4811 Buckley Rd",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883676",
            "country_code": "US",
            "telephone_number": "518-488-8193",
            "fax_number": "315-457-9854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "300226",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD17120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.