Individual provider Active NPI

Tyler D. Hauswald, PA-C

  • Physician Assistant
  • Wahoo, NE
National Provider Identifier
1740270446
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
NE00935 Issued in NE
Practice address
1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152
Phone
(402) 443-4191
Fax
(402) 443-1402
NPI assigned
Oct 24, 2005
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 935 NE
Physician Assistant 363A00000X NE00935 NE Primary

Addresses

Primary practice location

1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152

Mailing address

1760 County Road J
Saunders Medical Center
Wahoo, NE 68066-4152
Phone (402) 443-4191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000800 NE Practitioner - Physician Assistant 7315913274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saunders Medical CenterGroup PAC ID 2567371784, 31 clinicians

Practice addresses (Care Compare)

1760 County Rd J
Wahoo, NE 68066-4152
Phone (402) 443-4191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001410IAMDPhysical Therapy Assistant
NE00935NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saunders Medical Center CurrentSince Aug 18, 2010 Accepting new patients
Saunders Medical Center Current Accepting new patients
Saunders Medical Center Past Accepting new patients

Locations

1760 County Road J
Wahoo, NE 68066
Phone (402) 443-4191

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/06e9d567-9657-447f-97fb-d967654387e7/

Organizations & group practices 4

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 3

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1740270446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 COUNTY ROAD J",
            "address_2": "SAUNDERS MEDICAL CENTER",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664152",
            "telephone_number": "402-443-4191",
            "fax_number": "402-443-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 COUNTY ROAD J",
            "address_2": "SAUNDERS MEDICAL CENTER",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664152",
            "telephone_number": "402-443-4191",
            "fax_number": "402-443-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSWALD",
        "first_name": "TYLER",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "935",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "NE00935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

Sources for this page

Verify at the official NPI Registry.