Tyler Tidwell, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07001297A Issued in IN

Practice address

4233 Gateway Blvd
Newburgh, IN 47630-8900

Phone

(812) 858-5786

Fax

(812) 490-4512

NPI assigned

Mar 27, 2015

Last updated

Nov 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
• Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ttidwell164592@direct.deaconess.com

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Podiatrist

  Medicare reassignment NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Family Medicine Physician
  • Morganfield, KY
  • NPI 1891941688
  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310
  NPD
• Deaconess Clinic Inc.

  dba Deaconess Clinic II

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1033365986

  Podiatrist

  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Internal Medicine Physician
  • Henderson, KY
  • NPI 1154607398
  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Rural Health Clinic/Center
  • Princeton, IN
  • NPI 1528214400
  NPD (past)

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

• Deaconess Hospital Inc

  dba The Women's Hospital

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation
• Methodist Health, Inc.

  dba Deaconess Henderson Hospital

  • General Acute Care Hospital
  • Henderson, KY
  • NPI 1083759633
  Care Compare affiliation

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1629462635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308900",
            "telephone_number": "812-858-5786",
            "fax_number": "812-490-4512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Merritt Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424202788",
            "country_code": "US",
            "telephone_number": "270-827-0064",
            "fax_number": "270-826-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "TYLER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "244018",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001297A",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "41000347A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Solomon Thomas, APRN
• Katherine Allison Thomas, RN
• Kyra Thompson, RBT
• Thrive Therapy and Wellness LLC (Thrive at Home Therapy and Wellness)
• Amanda Tichenor, RBT
• Lauren Tillman, APN, CNP
• Joylita Timmons, LMT
• Tindle Speech Therapy
• Blake Edward Titzer, DO
• Michael L Titzer, M.D.

• Podiatrist in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.