Individual provider Active NPI

Tyler Gid Jenkins

  • Clinical Pathology Physician
  • Marysville, CA
National Provider Identifier
1619210937
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
A135377 Issued in CA
Practice address
726 4TH St
Marysville, CA 95901-5656
Phone
(530) 749-4467
NPI assigned
Apr 4, 2013
Last updated
Oct 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X A135377 CA Primary

Addresses

Primary practice location

726 4TH St
Marysville, CA 95901-5656

Mailing address

PO Box 3067
Yuba City, CA 95992-3067
Phone (530) 751-4784

Other practice location 1

2441 Olive Ave
Altadena, CA 91001-5549
Phone (707) 616-8962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191016000373 CA Practitioner - Pathology 0648501098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Southern California Keck School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rideout Memorial HospitalGroup PAC ID 9234036088, 88 clinicians

Practice addresses (Care Compare)

726 4TH St
Marysville, CA 95901-5656
Phone (530) 740-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.08 of 100Reported as group
Quality
83.33
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A135377CAMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rideout Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients

Locations

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1531 Plumas Ct
Ste B
Yuba City, CA 95991
Phone (530) 674-2434

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1619210937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3067",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959923067",
            "telephone_number": "530-751-4784",
            "fax_number": "530-751-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 4TH ST",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959015656",
            "telephone_number": "530-749-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2441 Olive Ave",
            "address_purpose": "LOCATION",
            "city": "Altadena",
            "state": "CA",
            "postal_code": "910015549",
            "country_code": "US",
            "telephone_number": "707-616-8962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "TYLER",
        "middle_name": "GID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "CA",
            "license": "A135377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

Verify at the official NPI Registry.