Individual provider Active NPI

Tyler Rummel, D.O.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1801109731
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
02004540A Issued in IN
Practice address
714 N Senate Ave
Suite 100
Indianapolis, IN 46202-3763
Phone
(317) 715-6401
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101018619 MI
Diagnostic Radiology Physician 2085R0202X 02004540A IN Primary

Addresses

Primary practice location

714 N Senate Ave
Suite 100
Indianapolis, IN 46202-3763

Mailing address

296 Cove View Dr
Waterford, MI 48327-3783
Phone (231) 357-5419

Other identifiers 1

IdentifierTypeStateIssuer
201320250MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160603000584 MI Practitioner - Diagnostic Radiology 1557503695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Muskegon, PCGroup PAC ID 1355241191, 22 clinicians

Practice addresses (Care Compare)

1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 728-4948

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.54
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018619MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Muskegon PC Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

3535 Park St
Ste 105
Norton Shores, MI 49444
Phone (231) 739-7191

Organizations & group practices 1

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 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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1801109731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 COVE VIEW DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273783",
            "telephone_number": "231-357-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N SENATE AVE",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023763",
            "telephone_number": "317-715-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMMEL",
        "first_name": "TYLER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101018619",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "02004540A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201320250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.