Individual provider Active NPI

James M Tytko, MD

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1720071012
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35046245 Issued in OH
Practice address
2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783
Phone
(937) 558-3900
Fax
(937) 558-3999
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 35046245 OH
Family Medicine Physician 207Q00000X 35046245 OH Primary

Addresses

Primary practice location

2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783

Mailing address

2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783
Phone (937) 558-3900

Other identifiers 2

IdentifierTypeStateIssuer
080152126OtherOHMEDICARE RR
0511986MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jtytko3204@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000422 OH Practitioner - Family Practice 7911035977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35046245OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Feb 23, 2010 Accepting new patients
Kettering Independent Medical Group Inc Family Medicine CurrentSince Jun 12, 2023 Accepting new patients
Alliance Physicians Inc Family Medicine CurrentSince Feb 23, 2010 Accepting new patients

Locations

2145 N Fairfield Rd
Ste 100
Beavercreek, OH 45431
Phone (937) 558-3900

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

6438 Wilmington Pike
Ste 100
Dayton, OH 45459
Phone (937) 558-3840

3490 Far Hills Ave
Lowr
Kettering, OH 45429
Phone (937) 297-7771

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

33 W Rahn Rd
Kettering, OH 45429
Phone 9374338990 ext. 102

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 3

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1720071012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312783",
            "telephone_number": "937-558-3900",
            "fax_number": "937-558-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312783",
            "telephone_number": "937-558-3900",
            "fax_number": "937-558-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYTKO",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35046245",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35046245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "080152126",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0511986",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtytko3204@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2145 N Fairfield Rd Ste 100",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2145 N Fairfield Rd Ste 100",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.