Active NPI
Avera Tyler
Doing business as Avera Tyler Hospital
- Critical Access Hospital
- Tyler, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- Legal business name
- AVERA TYLER
- Doing business as
- Avera Tyler Hospital
- Practice address
- 240 Willow St.
Tyler, MN 56178-0240 - Phone
- (507) 247-5521
- Fax
- (507) 247-5972
- NPI assigned
- May 19, 2006
- Last updated
- Dec 2, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debbie Streier
- Title
- Ceo
- Phone
- (507) 537-9160
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | MN | Primary |
Addresses
Primary practice location
240 Willow St.
Tyler, MN 56178-0240
Mailing address
240 Willow St.
Tyler, MN 56178-0240
Phone (507) 247-5521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599245100 | Medicaid | MN | |
| 1889HAL | Other | MN | BLUE CROSS BLUE SHIELD |
Other names 1
- Avera Tyler Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000411 | MN | Part A Provider - Critical Access Hospital | 9638088537 |
Receives reassigned benefits from 36 practitioners Practice locations: Tyler, MN |
| O20170630001868 | MN | Part B Supplier - Clinic/Group Practice | 9638088537 |
Receives reassigned benefits from 58 practitioners 3 other NPIs on this enrollment Practice locations: Tyler, MN; Lake Benton, MN; Ivanhoe, MN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1801840517. Details of each certification follow.
Hospital certification: CCN 241348
- Legal name
- AVERA TYLER
- Doing business as
- AVERA TYLER HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Sep 1, 2003
- Last certification
- Apr 16, 2025
- Beds
- 20
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Incorporated
- Nov 30, 1961 in MN
- Enrollment address
- 240 Willow St
Tyler, MN 56178-1166
Related certifications (CCN) 3
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba Avera Lake Benton Clinic
- Rural Health Clinic/Center
- Lake Benton, MN
- NPI 1003869892
Parent provider
-
- Medicare Defined Swing Bed Hospital Unit
- Tyler, MN
- NPI 1326102237
-
dba Avera Medical Group Tyler
- Rural Health Clinic/Center
- Tyler, MN
- NPI 1649223439
Parent provider
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Avera Lake Benton Clinic
- Rural Health Clinic/Center
- Lake Benton, MN
- NPI 1003869892
9638088537
-
dba Avera Medical Group Tyler
- Rural Health Clinic/Center
- Tyler, MN
- NPI 1649223439
9638088537
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Avera Lake Benton Clinic
- Rural Health Clinic/Center
- Lake Benton, MN
- NPI 1003869892
O20170630001868
-
dba Avera Medical Group Ivanhoe
- Rural Health Clinic/Center
- Ivanhoe, MN
- NPI 1063949089
O20170630001868
-
dba Avera Medical Group Tyler
- Rural Health Clinic/Center
- Tyler, MN
- NPI 1649223439
O20170630001868
Care Compare: Hospital
Medicare Care Compare- Listed as
- Avera Tyler Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Avera Tyler
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medicare Defined Swing Bed Hospital Unit
- Tyler, MN
- NPI 1326102237
-
- General Acute Care Hospital
- Tyler, MN
- NPI 1184832891
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Avera Medical Group Radiation Oncology Marshall
- Radiation Oncology Clinic/Center
- Marshall, MN
- NPI 1649688623
Member Of
Ownership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| James Francis Dover | Corporate Officer | Oct 23, 2023 | |
| Jill Vroman | Corporate Director | Jul 1, 2023 | |
| Debra Ann Streier | Corporate Officer | Feb 1, 2021 | |
| Operational/Managerial Control | Feb 1, 2021 | ||
| Tim O'Leary | Corporate Director | Jul 1, 2023 | |
| Jodelle a Zimmerman | Corporate Director | Jul 1, 2018 | |
| Sharon Hennen | Corporate Director | Jul 1, 2023 | |
| Amanda Sieling | Corporate Director | Jul 1, 2018 | |
| Karie Engle Novak | Corporate Director | Jul 1, 2024 | |
| Lavonne Annette Koenen | Corporate Director | Jul 1, 2020 | |
| Thomas J Kooiman | Corporate Officer | May 29, 2022 | |
| Operational/Managerial Control | May 29, 2022 | ||
| Avera Marshall | 5% Or Greater Direct Ownership Interest | Mar 1, 2016 | 100% |
| Operational/Managerial Control | Mar 1, 2016 | ||
| Christy Ann Coudron | Corporate Officer | Oct 1, 2020 | |
| Julie Lautt | Corporate Officer | Mar 1, 2020 | |
| Thomas Matthew Lorang | Corporate Director | Jul 1, 2024 | |
| Curtis Ronald Louwagie | Corporate Director | Jul 1, 2018 | |
| Avera Health | 5% Or Greater Indirect Ownership Interest | Mar 1, 2016 | 100% |
Owners & managing parties with NPI records 16
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Avera@Home Southwest Minnesota
- Home Health Agency
- Marshall, MN
- NPI 1033535547
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Dialysis Marshall
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Marshall, MN
- NPI 1154856839
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Morningside Heights Care Center
- Skilled Nursing Facility
- Marshall, MN
- NPI 1255329033
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Eye Care Dawson
- Optometrist
- Dawson, MN
- NPI 1396513370
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Eye Care Tracy
- Optometrist
- Tracy, MN
- NPI 1487958062
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Marshall Regional Medical Center
- Critical Access Hospital
- Marshall, MN
- NPI 1568401016
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Eye Care Marshall
- Durable Medical Equipment & Medical Supplies
- Marshall, MN
- NPI 1669622031
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Marshall Regional Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Marshall, MN
- NPI 1700070430
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Marshall Regional Medical Center
- Psychiatric Hospital Unit
- Marshall, MN
- NPI 1750508412
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Eye Care Springfield
- Ophthalmology Physician
- Springfield, MN
- NPI 1922316041
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera Eye Care Canby
- Optometrist
- Canby, MN
- NPI 1952179939
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Avera@Home Southwest Minnesota
- Community Based Hospice Care Agency
- Marshall, MN
- NPI 1952727463
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 91
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Avera Granite Falls Health Center Swingbed
- Medicare Defined Swing Bed Hospital Unit
- Granite Falls, MN
- NPI 1578106498
Avera Health, Avera Marshall
-
dba Avera Granite Falls Care Center
- Skilled Nursing Facility
- Granite Falls, MN
- NPI 1679116503
Avera Marshall
-
dba Avera Granite Falls Health Center
- Critical Access Hospital
- Granite Falls, MN
- NPI 1700429610
Avera Health, Avera Marshall
-
dba Avera@Home Southwest Minnesota
- Home Health Agency
- Marshall, MN
- NPI 1033535547
Avera Health
-
dba Avera Morningside Heights Care Center
- Skilled Nursing Facility
- Marshall, MN
- NPI 1255329033
Avera Health
-
dba Avera Marshall Regional Medical Center
- Critical Access Hospital
- Marshall, MN
- NPI 1568401016
Avera Health
-
dba Avera Marshall Regional Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Marshall, MN
- NPI 1700070430
Avera Health
-
dba Avera Marshall Regional Medical Center
- Psychiatric Hospital Unit
- Marshall, MN
- NPI 1750508412
Avera Health
-
dba Avera@Home Southwest Minnesota
- Community Based Hospice Care Agency
- Marshall, MN
- NPI 1952727463
Avera Health
-
dba Avera Lake Benton Clinic
- Rural Health Clinic/Center
- Lake Benton, MN
- NPI 1003869892
Avera Health, Avera Marshall
-
- Medicare Defined Swing Bed Hospital Unit
- Tyler, MN
- NPI 1326102237
Avera Health, Avera Marshall
-
dba Avera Medical Group Tyler
- Rural Health Clinic/Center
- Tyler, MN
- NPI 1649223439
Avera Health, Avera Marshall
Practitioners & affiliated clinicians
Practitioners 64
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Tyler, MN
- NPI 1619626652
-
- Otolaryngology Physician
- Willmar, MN
- NPI 1396963922
-
- Nurse Practitioner
- Tyler, MN
- NPI 1205271756
-
- Internal Medicine Physician
- Crookston, MN
- NPI 1700271012
-
- Surgery Physician
- Willmar, MN
- NPI 1700852589
-
- Endocrinology, Diabetes & Metabolism Physician
- Tyler, MN
- NPI 1174501159
-
- Family Medicine Physician
- Tyler, MN
- NPI 1134563653
-
- Student in an Organized Health Care Education/Training Program
- Tyler, MN
- NPI 1669906053
-
- Family Medicine Physician
- Granite Falls, MN
- NPI 1619943404
-
- Acute Care Nurse Practitioner
- Sioux Falls, SD
- NPI 1033548854
MN
-
- Physician Assistant
- Marshall, MN
- NPI 1013647080
Affiliated clinicians 19
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Tyler, MN
- NPI 1174501159
Hospital
-
- Student in an Organized Health Care Education/Training Program
- Tyler, MN
- NPI 1669906053
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1669939200000",
"number": "1801840517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 WILLOW ST.",
"city": "TYLER",
"state": "MN",
"postal_code": "561780240",
"telephone_number": "507-247-5521",
"fax_number": "507-247-5972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 WILLOW ST.",
"city": "TYLER",
"state": "MN",
"postal_code": "561780240",
"telephone_number": "507-247-5521",
"fax_number": "507-247-5972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA TYLER",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A",
"authorized_official_last_name": "STREIER",
"authorized_official_first_name": "DEBBIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "507-537-9160"
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599245100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1889HAL",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Tyler Hospital",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avera Tyler Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tyler, MN
- Align Family Chiropractic LLC
- Kassandra Elizabeth Anderson, FNP-C
- Avera Marshall (Avera Medical Group Dental Care)
- Avera Tyler
- Avera Tyler (Avera Medical Group Tyler)
- Avera Tyler (Avera Sunrise Manor)
- Avera Tyler (Ridgeview Hospice)
- Avera Tyler (Tyler Home Care)
- Gail Beck
- Christopher Donald Determan, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.