Active NPI
Brian Tyson, MD
- Internal Medicine Physician
- Shelby Township, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301108384
- Practice address
- 50505 Schoenherr Rd Ste 340
Shelby Township, MI 48315-3140 - Phone
- (586) 731-8400
- Fax
- (586) 731-8406
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 4301108384 | MI | |
| Internal Medicine Physician | 207R00000X | 036-151246 | IL | |
| Hospitalist Physician | 208M00000X | 036-151246 | IL | |
| Internal Medicine Physician | 207R00000X | 4301108384 | MI | Primary |
Addresses
Primary practice location
50505 Schoenherr Rd Ste 340
Shelby Township, MI 48315-3140
Mailing address
50505 Schoenherr Rd Ste 340
Shelby Township, MI 48315-3140
Phone (586) 731-8400
Other practice location 1
1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-4325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 69.5
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-151246 | IL | MD | Internal Medicine Physician |
| 4301108384 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients |
Locations
1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
dba FCH Greenville Family Medicine Clinic
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1740664499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50505 SCHOENHERR RD STE 340",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483153140",
"telephone_number": "586-731-8400",
"fax_number": "586-731-8406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50505 SCHOENHERR RD STE 340",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483153140",
"telephone_number": "586-731-8400",
"fax_number": "586-731-8406"
}
],
"practiceLocations": [
{
"address_1": "1000 Health Center Dr",
"address_purpose": "LOCATION",
"city": "Mattoon",
"state": "IL",
"postal_code": "619384644",
"country_code": "US",
"telephone_number": "217-238-4325",
"fax_number": "217-348-4290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TYSON",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MI",
"license": "4301108384",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-151246",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036-151246",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301108384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.