Individual provider Active NPI

Tyler Wayne Fraser, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Memphis, TN
National Provider Identifier
1629464896
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
62663 Issued in TN
Practice address
1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone
(901) 767-8662
Fax
(901) 767-8666
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 62663 TN Primary

Addresses

Primary practice location

1244 Primacy Pkwy
Memphis, TN 38119-0201

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5754
Phone (901) 786-4198

Other practice location 1

2100 Exeter Rd
Germantown, TN 38138-3966
Phone (901) 641-3000

Other practice location 2

3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone (901) 381-4664

Other identifiers 1

IdentifierTypeStateIssuer
62663OtherTNTN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210609001060 TN Practitioner - Orthopedic Surgery 6103257779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1244 Primary Pkwy
Memphis, TN 38119
Phone (901) 641-3000

8059 Stage Hills Blvd
Bartlett, TN 38133-4071
Phone (901) 383-4515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue14
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC CurrentSince Aug 1, 2021 Accepting new patients
MSK Group, PC Foot and Ankle Surgery CurrentSince Aug 1, 2021 Accepting new patients
MSK Group PC Past Accepting new patients

Locations

8010 Stage Hills Blvd
Bartlett, TN 38133
Phone (901) 937-3200

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

2100 Exeter Rd
Memphis, TN 38138
Phone (901) 757-1350

1244 Primacy Pkwy
Memphis, TN 38119
Phone (901) 767-8662

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

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 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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1629464896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-786-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8662",
            "fax_number": "901-767-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-373-0804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3045 Kate Bond Rd",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "381334004",
            "country_code": "US",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-0804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRASER",
        "first_name": "TYLER",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "TN",
            "license": "62663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "62663",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.