Derek Leon Tyus

Primary specialty

Social WorkerTaxonomy code 104100000X

License

130839 Issued in WI

Practice address

1320 Mendota St Ste 120
Madison, WI 53714-1060

Phone

(608) 280-2700

NPI assigned

Dec 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1689144404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MENDOTA ST STE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141060",
            "telephone_number": "608-280-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYUS",
        "first_name": "DEREK",
        "middle_name": "LEON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18134",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Kari Tyler, DO
• Julia R Tymorek, LPC
• Elisabetta Menalli Tyriver, MD
• Steven Tyska, MD
• Abigail Tyson
• U.S. Dr Monitoring, Inc.
• Justin U'Ren
• Erica Ubersox, A.S., HS-BCP
• Khadijatul Uddin, NP
• Chinelo S Ude, M.D.

• Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.