Individual provider Active NPI

Elyse C Tinker, D.O.

  • Family Medicine Physician
  • Norwalk, OH
National Provider Identifier
1629415484
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.012625 Issued in OH
Practice address
257 Benedict Ave Ste 1
Norwalk, OH 44857-2715
Phone
(419) 668-1101
Fax
(419) 668-1191
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
Yes

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 34.012625 OH Primary

Addresses

Primary practice location

257 Benedict Ave Ste 1
Norwalk, OH 44857-2715

Mailing address

257 Benedict Ave.
BLDG C. Ste 1
Norwalk, OH 44857
Phone (419) 668-1101

Other identifiers 1

IdentifierTypeStateIssuer
0215696MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170608002547 OH Practitioner - Family Practice 0547483869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Family Practice, Inc.Group PAC ID 7911802848, 6 clinicians

Practice addresses (Care Compare)

257 Benedict Ave
Norwalk, OH 44857-2391

257 Benedict Ave
Suite C
Norwalk, OH 44857-2715
Phone (419) 668-1101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.012625OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Family Practice, Inc. Family Medicine CurrentSince Jul 24, 2017 Accepting new patients

Locations

257 Benedict Ave
Ste 1
Norwalk, OH 44857
Phone (419) 668-1101

257 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1101

257 Benedict Ave
Ste C
Norwalk, OH 44857
Phone (419) 668-1101

257 Benedict Ave
Ste C1
Norwalk, OH 44857
Phone (419) 668-1101

Interoperability endpoints

  • Direct secure messaging: etinker@nofp.gwaydirect.com
  • Direct secure messaging: etinker@nofp.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73146

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.

Hospital & facility affiliations 7

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629415484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BENEDICT AVE.",
            "address_2": "BLDG C. STE 1",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "44857",
            "telephone_number": "419-668-1101",
            "fax_number": "419-668-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 BENEDICT AVE STE 1",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572715",
            "telephone_number": "419-668-1101",
            "fax_number": "419-668-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKER",
        "first_name": "ELYSE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.012625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215696",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, OH

Sources for this page

Verify at the official NPI Registry.