Tyler Anthony Dickinson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10482 Issued in MN

Practice address

14884 Kirkwood Dr
Baxter, MN 56425-8451

Phone

(218) 824-5027

Fax

(218) 824-8011

NPI assigned

Aug 19, 2016

Last updated

Jun 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tria Orthopaedic Center LLC

  dba TRIA Orthopaedic Clinic

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1518273085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD
• Tria Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1346624384

  Physical Therapist

  NPD

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1730634783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 2111OQ",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14884 KIRKWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258451",
            "telephone_number": "218-824-5027",
            "fax_number": "218-824-8011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14884 Kirkwood Dr",
            "address_purpose": "LOCATION",
            "city": "Baxter",
            "state": "MN",
            "postal_code": "564258451",
            "country_code": "US",
            "telephone_number": "218-824-5027",
            "fax_number": "218-824-8011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 American Blvd W Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554314420",
            "country_code": "US",
            "telephone_number": "952-831-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "TYLER",
        "middle_name": "ANTHONY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Baxter, MN
• Providers in Baxter, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.