Individual provider Active NPI

Tyler Scott Clark, MD

  • Physical Medicine & Rehabilitation Physician
  • Billings, MT
National Provider Identifier
1831623826
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
12267283-1205 Issued in UT
Practice address
2900 12TH Ave N Ste 140W
Billings, MT 59101-7507
Phone
(406) 238-6726
NPI assigned
Apr 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10059361 TX
Physical Medicine & Rehabilitation Physician 208100000X 12267283-1205 UT Primary

Addresses

Primary practice location

2900 12TH Ave N Ste 140W
Billings, MT 59101-7507

Mailing address

7703 Floyd Curl Dr
MC 7798
San Antonio, TX 78229-3901

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tclark209482@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20210827001715 UT Practitioner - Physical Medicine and Rehabilitation 3173890449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

50 N Medical Dr
University of Utah Hospital Pmandr
Salt Lake City, UT 84132-0100
Phone (801) 587-6336

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10059361TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Montana, PSC CurrentSince Jul 25, 2022 Accepting new patients
University of Utah Specialty Services CurrentSince Jul 1, 2021 Accepting new patients
University of Utah Specialty Services Current Accepting new patients
Ortho Montana, PSC CurrentSince Jul 25, 2022 Accepting new patients
University of Utah Specialty Services Physical Medicine & Rehabilitation CurrentSince Jul 1, 2021 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
University of Utah Specialty Services Past Accepting new patients

Locations

2900 12th Ave N
Ste 140W
Billings, MT 59101
Phone (406) 237-5050

1739 Spring Creek Rd
Billings, MT 59102
Phone (406) 237-5050

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 7

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1831623826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "MC 7798",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N STE 140W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017507",
            "telephone_number": "406-238-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10059361",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "12267283-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tclark209482@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.