NPIMap

Individual provider Active NPI

Tyler Akira Ice

  • Internal Medicine Physician
  • Nampa, ID
National Provider Identifier
1659900736
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M-17236 Issued in ID
Practice address
4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone
(714) 318-0439
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M-17236 ID Primary
Hospitalist Physician 208M00000X M-17236 ID

Addresses

Primary practice location

4300 E Flamingo Ave
Nampa, ID 83687-3138

Mailing address

928 S Austin Way
Anaheim, CA 92808-2350
Phone (714) 318-0439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231127000555 ID Practitioner - Internal Medicine 7012330970 Reassigns benefits to 1 organization
I20251212001409 IN Practitioner - Hospitalist 7012330970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Wayne State University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Albany Hospitalist Group LLCGroup PAC ID 4880041409, 69 clinicians
Sound Physicians of IdahoGroup PAC ID 4688705346, 47 clinicians

Practice addresses (Care Compare)

1850 State St
New Albany, IN 47150-4990
Phone (812) 944-7701

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

Hospital & facility affiliations

  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • Baptist Health Floyd Hospital, New Albany, IN, CCN 150044
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-17236IDMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Idaho Internal Medicine CurrentSince Sep 10, 2023 Accepting new patients
New Albany Hospitalist Group, LLC Hospitalist CurrentSince Dec 1, 2025 Accepting new patients

Locations

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: tice2857360@direct.trinity-health.org

Organizations & group practices 2

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 8

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1659900736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S AUSTIN WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928082350",
            "telephone_number": "714-318-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873138",
            "telephone_number": "714-318-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "TYLER",
        "middle_name": "AKIRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-17236",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M-17236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.