Individual provider Active NPI

Jared M Tyler, M.D.

  • Anesthesiology Physician
  • St George, UT
National Provider Identifier
1609198142
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
90140801205 Issued in UT
Practice address
1380 E Medical Center Dr
St George, UT 84790-2123
Phone
(801) 856-8998
NPI assigned
Feb 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X AZ16525451928 AZ
Anesthesiology Physician 207L00000X 90140801205 UT Primary

Addresses

Primary practice location

1380 E Medical Center Dr
St George, UT 84790-2123

Mailing address

2444 E 2860 S
St George, UT 84790-4707

Other practice location 1

1200 College Dr
Rock Springs, WY 82901-5868
Phone (307) 362-8338

Other identifiers 1

IdentifierTypeStateIssuer
AZ16525451928OtherAZRESIDENT LIMITED LICENSE ARIZONA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140725000514 UT Practitioner - Anesthesiology 8022234186 Reassigns benefits to 1 organization
I20240123003595 WY Practitioner - Anesthesiology 8022234186 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Utah School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Lincoln County Hospital DistrictGroup PAC ID 4789580218, shared by 4 NPIs, 66 clinicians

Practice addresses (Care Compare)

10764 N US Hwy 30
Cokeville, WY 83114
Phone (307) 885-5970

110 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5852

120 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5870

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AZ16525451928AZMDAnesthesiology Physician
90140801205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Anesthesia LLC Anesthesiology CurrentSince Jul 28, 2014 Accepting new patients
North Lincoln County Hospital District CurrentSince Feb 1, 2024 Accepting new patients
North Lincoln County Hospital District Current Accepting new patients
Memorial Hospital of Sweetwater County CurrentSince May 1, 2024 Accepting new patients

Locations

3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

22 S 9th E
Slc, UT 84102
Phone (801) 328-7522

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

1180 College Dr
Rock Springs, WY 82901
Phone (307) 352-8125

Organizations & group practices 4

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": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1609198142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 E 2860 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "801-856-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 College Dr",
            "address_purpose": "LOCATION",
            "city": "Rock Springs",
            "state": "WY",
            "postal_code": "829015868",
            "country_code": "US",
            "telephone_number": "307-362-8338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "AZ16525451928",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "90140801205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT LIMITED LICENSE ARIZONA",
            "identifier": "AZ16525451928",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.