Tyler Joseph Adamski, DNP
Individual provider Active NPI Family Nurse Practitioner · Sullivan, MO
NPI 1649708264 · NPPES record last updated May 13, 2021
Key facts
- NPI
- 1649708264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2016040136 (MO)
- Practice address
- 751 Sappington Bridge Rd
Sullivan, MO 63080-2354 - Phone
- (573) 468-4186
- NPI assigned
- May 26, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Missouri Baptist Hospital of Sullivan
Practice addresses (Care Compare)
102 Ozark Dr
Suite B
Cuba, MO 65453-1664
Phone (573) 860-6600
Hospital & facility affiliations
- Missouri Baptist Sullivan Hospital
- Phelps County Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200310001939 | MO | Practitioner - Nurse Practitioner | 6204264054 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016040136 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Baptist Hospital of Sullivan | Current | Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Current |
Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Current |
Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Current |
Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Past | Accepting new patients |
Locations
102 Ozark Dr
#B
Cuba, MO 65453
Phone (573) 860-6600
751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343
965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2016040136 | MO | Yes |
Addresses
Primary practice location
751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Mailing address
751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Phone (573) 468-4186
Other practice location 1
3201 S Mester St
Saint Charles, MO 63301-8087
Phone (636) 448-8127
Other practice location 2
232 S Woods Mill Rd
Chesterfield, MO 63017-3406
Phone (314) 205-6100 ext. 4396
Other practice location 3
965 Mattox Dr
Sullivan, MO 63080-2365
Phone (573) 860-6000
Other practice location 4
4530 LeMay Ferry Rd Ste M
Saint Louis, MO 63129-1600
Phone (314) 656-6127
Other practice location 5
102 Ozark Dr Ste B
Cuba, MO 65453-1664
Phone (573) 885-6600
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in Sullivan, MO
- Bryan Gabriel Acree
- Advanced Psychiatric Services
- Armela Agasino
- Ambreen Ahmed
- Air Evac EMS Inc
- Naureen Ali
All providers in Sullivan, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.