NPIMap

Individual provider Active NPI

Tyler A Weigang, M.D.

  • Family Medicine Physician
  • Evans, CO
National Provider Identifier
1619388089
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55777 Issued in CO
Practice address
2930 11TH Ave
Evans, CO 80620-1011
Phone
(970) 353-9403
Fax
(970) 353-5884
NPI assigned
May 19, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55777 CO Primary

Addresses

Primary practice location

2930 11TH Ave
Evans, CO 80620-1011

Mailing address

2930 11TH Ave
Evans, CO 80620
Phone (970) 350-4606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20171010002895 CO Practitioner - Family Practice 1052531118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

302 3Rd St SE
Suite 150
Loveland, CO 80537-6419
Phone (970) 669-4855

4617 W 20TH St
Unit a Select PT
Greeley, CO 80634-3207
Phone (970) 352-9022

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55777COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Sep 25, 2017 Accepting new patients
Sunrise Community Health CurrentSince Sep 25, 2017 Accepting new patients
Sunrise Community Health Family Medicine Current Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Interoperability endpoints

  • Direct secure messaging: tyler.weigang.1@27043.direct.athenahealth.com

Organizations & group practices 3

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 12

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": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619388089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "80620",
            "telephone_number": "970-350-4606",
            "fax_number": "970-350-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-353-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGANG",
        "first_name": "TYLER",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "55777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, CO

Sources for this page

Verify at the official NPI Registry.