Individual provider Active NPI

Tyler C Price, M.D.

  • Emergency Medicine Physician
  • Bismarck, ND
National Provider Identifier
1811159403
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11887 Issued in ND
Practice address
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone
(701) 530-7000
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11887 ND Primary

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501-4520

Mailing address

PO Box 997
Bismarck, ND 58502-0997
Phone (701) 530-7000

Other identifiers 1

IdentifierTypeStateIssuer
1452784MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, SD2 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
I20111103000931 ND Practitioner - Emergency Medicine 6305019522 Reassigns benefits to 1 organization
I20180918001906 SD Practitioner - Emergency Medicine 6305019522 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Aug 1, 2018 Accepting new patients
Avera McKennan CurrentSince Aug 1, 2018 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 1, 2011 Accepting new patients
St Alexius Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

Interoperability endpoints

  • Direct secure messaging: tyler.price.1@16187.direct.athenahealth.com

Organizations & group practices 5

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1811159403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585020997",
            "telephone_number": "701-530-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "TYLER",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "11887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452784",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.