NPIMap

Individual provider Active NPI

Tyler Mouw, M.D.

  • Surgical Oncology Physician
  • Lubbock, TX
National Provider Identifier
1588058499
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
T4007 Issued in TX
Practice address
3601 4TH St
Department of Surgery
Lubbock, TX 79430-3700
Phone
(806) 743-2373
NPI assigned
Mar 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Oncology Physician 2086X0206X T4007 TX Primary

Addresses

Primary practice location

3601 4TH St
Department of Surgery
Lubbock, TX 79430-3700

Mailing address

3601 4TH St
Lubbock, TX 79430-0002
Phone (806) 743-2373

Other practice location 1

315 E Broadway Ste 312
Louisville, KY 40202-3700
Phone (913) 588-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220815000382 TX Practitioner - Surgical Oncology 3274830534 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 29, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 29, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Organizations & group practices 7

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 5

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

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center Lubbock 363 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-2800

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

NPI Registry JSON

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1588058499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794303700",
            "telephone_number": "806-743-2373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Broadway Ste 312",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023700",
            "country_code": "US",
            "telephone_number": "913-588-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUW",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "T4007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.