Individual provider Active NPI

Tyler M. Ferris, D.O.

  • Family Medicine Physician
  • Brookings, OR
National Provider Identifier
1629496526
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO204255 Issued in OR
Practice address
500 5TH St
Brookings, OR 97415-9702
Phone
(541) 412-2000
Fax
(541) 412-2081
NPI assigned
Mar 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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 DO204255 OR Primary

Addresses

Primary practice location

500 5TH St
Brookings, OR 97415-9702

Mailing address

500 5TH St
Brookings, OR 97415-9702
Phone (541) 412-2000

Other identifiers 1

IdentifierTypeStateIssuer
1487696985OtherORCURRY GENERAL HOSPITAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170713002135 UT Practitioner - Family Practice 2860781135 Reassigns benefits to 1 organization
I20211101001503 OR Practitioner - Family Practice 2860781135 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curry Health District CurrentSince Dec 1, 2021 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2017 Accepting new patients
Curry Health District CurrentSince Dec 1, 2021 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients
Curry Health District Past Accepting new patients

Locations

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

1000 N Main St
Richfield, UT 84701
Phone (435) 893-4100

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • Direct secure messaging: tferris3366602@oc.providencedirect.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1629496526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-2000",
            "fax_number": "541-412-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-2000",
            "fax_number": "541-412-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "TYLER",
        "middle_name": "M.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-29",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO204255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY GENERAL HOSPITAL NPI",
            "identifier": "1487696985",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, OR

Sources for this page

Verify at the official NPI Registry.