Individual provider Active NPI

Tylor Kock, D.O.

  • Emergency Medicine Physician
  • Fargo, ND
National Provider Identifier
1760123053
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
V1813 Issued in TX
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 417-2575
NPI assigned
Apr 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22382 ND
Emergency Medicine Physician 207P00000X V1813 TX Primary

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

600 Elizabeth St Ofc 9.209
Corpus Christi, TX 78404-2235
Phone (361) 902-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240807001629 TX Practitioner - Emergency Medicine 2567846462 Reassigns benefits to 2 organizations
I20250829001724 ND Practitioner - Emergency Medicine 2567846462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 5074
Sioux Falls, SD 57117

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22382NDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Refugio County Memorial Hospital District Emergency Medicine CurrentSince Jul 31, 2024 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Gulf Coast Emergency Physicians, PLLC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Refugio County Memorial Hospital District CurrentSince Jul 31, 2024 Accepting new patients
Sanford Medical Center Fargo Emergency Medicine Current Accepting new patients

Locations

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

600 Elizabeth St
Ofc 9209
Corpus Christi, TX 78404
Phone (361) 902-4100

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

107 Swift St
Refugio, TX 78377
Phone (361) 526-2321

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1760123053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-417-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Elizabeth St Ofc 9.209",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784042235",
            "country_code": "US",
            "telephone_number": "361-902-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCK",
        "first_name": "TYLOR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-02",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "22382",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V1813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.