Individual provider Active NPI

Tylor Kersten, MD

  • General Practice Physician
  • Chesterfield, MO
National Provider Identifier
1780179002
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2023009962 Issued in MO
Practice address
100 Chesterfield Business Pkwy FL 2
Chesterfield, MO 63005-1271
Phone
(543) 994-6739
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2023009962 MO Primary

Addresses

Primary practice location

100 Chesterfield Business Pkwy FL 2
Chesterfield, MO 63005-1271

Mailing address

6656 Highway BB
Washington, MO 63090-6082
Phone (314) 939-0488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230804001817 MO Practitioner - General Practice 4688902265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vohra Wound Physicians of FL LLCGroup PAC ID 6406039882, 73 clinicians

Practice addresses (Care Compare)

1024 Adams St
Jefferson City, MO 65101-3408
Phone (573) 635-1320

872 College Blvd
Osage Beach, MO 65065-8408
Phone (573) 302-0900

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue186
Removal of skin lesions14
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of FL, LLC General Practice CurrentSince Jan 13, 2024 Accepting new patients
Signify Health, LLC General Practice CurrentSince Jul 2, 2023 Accepting new patients
Vohra Wound Physicians of FL, LLC CurrentSince Jan 13, 2024 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

100 Chesterfield Business Pkwy
Fl 2
Chesterfield, MO 63005
Phone (314) 355-8585

1024 Adams St
Jefferson Cty, MO 65101
Phone (573) 635-1320

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

2840 W Clay St
Saint Charles, MO 63301
Phone (636) 724-0829

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1780179002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6656 HIGHWAY BB",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630906082",
            "telephone_number": "314-939-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHESTERFIELD BUSINESS PKWY FL 2",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051271",
            "telephone_number": "543-994-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTEN",
        "first_name": "TYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2023009962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.