Individual provider Active NPI

Tyler Alan Ploss, DC

  • Chiropractor
  • Kokomo, IN
National Provider Identifier
1598389249
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003326A Issued in IN
Practice address
1873 E Sycamore St
Kokomo, IN 46901-5200
Phone
(765) 450-9153
NPI assigned
May 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003326A IN Primary
Chiropractor 111N00000X 2020014160 MO

Addresses

Primary practice location

1873 E Sycamore St
Kokomo, IN 46901-5200

Mailing address

19449 Ethan Allen LN
Westfield, IN 46074-9252
Phone (765) 419-1101

Other identifiers 1

IdentifierTypeStateIssuer
08003326AOtherININDIANA CHIROPRACTIC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221019000875 IN Practitioner - Chiropractic 5991171753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1873 E Sycamore St
Kokomo, IN 46901-5200
Phone (765) 450-9153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003326AINMDChiropractor
2020014160MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Untapped Chiropractic Chiropractor CurrentSince Sep 1, 2022 Accepting new patients
Excelsior Family Chiropractic LLC Chiropractor PastSince May 1, 2020 Accepting new patients

Locations

1873 E Sycamore St
Kokomo, IN 46901
Phone (765) 450-9153

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1598389249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19449 ETHAN ALLEN LN",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749252",
            "telephone_number": "765-419-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 E SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015200",
            "telephone_number": "765-450-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOSS",
        "first_name": "TYLER",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003326A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2020014160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA CHIROPRACTIC LICENSE",
            "identifier": "08003326A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.