Individual provider Active NPI

Stephen Louis Tyks, DC

  • Chiropractor
  • Skowhegan, ME
National Provider Identifier
1619086352
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR672 Issued in ME
Practice address
220 Madison Ave
Skowhegan, ME 04976-3009
Phone
(207) 474-0877
Fax
(207) 474-0878
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR672 ME Primary

Addresses

Primary practice location

220 Madison Ave
Skowhegan, ME 04976-3009

Mailing address

PO Box 3009
Skowhegan, ME 04976-3009
Phone (207) 474-0877

Other identifiers 2

IdentifierTypeStateIssuer
100042OtherMEANTHEM
1201B0000MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040109000340 ME Practitioner - Chiropractic 7810897634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

220 Madison Ave
Skowhegan, ME 04976-1356
Phone (207) 474-0877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR672MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tyks Chiropractic, Inc Chiropractor CurrentSince Jan 2, 2006 Accepting new patients

Organizations & group practices 1

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619086352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3009",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049763009",
            "telephone_number": "207-474-0877",
            "fax_number": "207-474-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MADISON AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049763009",
            "telephone_number": "207-474-0877",
            "fax_number": "207-474-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYKS",
        "first_name": "STEPHEN",
        "middle_name": "LOUIS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "100042",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1201B0000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.