NPIMap

Individual provider Active NPI

Tyler Ryan Stoltz, M.D.

  • Child & Adolescent Psychiatry Physician
  • Anchorage, AK
National Provider Identifier
1700236049
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
225500 Issued in AK
Practice address
4341 Tudor Centre Dr Ste 300
Anchorage, AK 99508-5904
Phone
(907) 729-2500
NPI assigned
Jun 17, 2016
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD-21956 HI
Psychiatry Physician 2084P0800X LL39543 SC
Psychiatry Physician 2084P0800X 39543 SC
Psychiatry Physician 2084P0800X A174699 CA
Child & Adolescent Psychiatry Physician 2084P0804X 225500 AK Primary

Addresses

Primary practice location

4341 Tudor Centre Dr Ste 300
Anchorage, AK 99508-5904

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-8901

Other practice location 1

15 Medical Park Suite 141
General Psychiatry Department
Columbia, SC 29203
Phone (803) 434-1433

Other practice location 2

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 309-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 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
I20210809002150 SC Practitioner - Psychiatry 3476836826 Reassigns benefits to 2 organizations
I20240822002591 TX Practitioner - Psychiatry 3476836826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcentral FoundationGroup PAC ID 5496663627, 168 clinicians

Practice addresses (Care Compare)

4341 Tudor Centre Dr
Anchorage, AK 99508-5904

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.77 of 100Reported as group
Quality
76.11
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A174699CAMDPsychiatry Physician
MD-21956HIMDPsychiatry Physician
LL39543SCMDPsychiatry Physician
225500AKMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers Psychiatry CurrentSince Apr 6, 2022 Accepting new patients
Aiken Regional Medical Centers LLC Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 1, 2024 Accepting new patients
Aiken Regional Medical Centers LLC CurrentSince Apr 6, 2022 Accepting new patients
Southcentral Foundation Current Accepting new patients
Three Rivers Behavioral Health LLC CurrentSince Jul 12, 2021 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

655 Medical Park Dr
Aiken, SC 29801
Phone (803) 641-5900

2900 Sunset Blvd
West Columbia, SC 29169
Phone (803) 744-3206

Interoperability endpoints

  • Direct secure messaging: tyler.stoltz.p1@direct.lifewell.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1700236049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-8901",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 TUDOR CENTRE DR STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-729-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Medical Park Suite 141",
            "address_2": "General Psychiatry Department",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-1433",
            "fax_number": "803-434-4062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-309-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLTZ",
        "first_name": "TYLER",
        "middle_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-21956",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL39543",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "39543",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A174699",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AK",
            "license": "225500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.