Martin S. Tyson, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2001010358 Issued in MO

Practice address

1155 W Parkview St
Suite 1G
Bolivar, MO 65613-8279

Phone

(417) 326-8700

Fax

(417) 328-6755

NPI assigned

Nov 30, 2006

Last updated

Dec 10, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT, NY, NJ3 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 3

Specialty

General Surgery

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foxhurst Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1730547522
  Medicare reassignment NPD
• Medical Services of Connecticut PLLC

  • Specialist
  • Farmington, CT
  • NPI 1215826516
  Medicare reassignment NPD
• Mott Haven Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1457873234
  Medicare reassignment NPD
• Pelham Pkwy Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1285156067
  Medicare reassignment NPD
• Bushwick Medical of New York LLC

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1720565922
  Medicare reassignment
• Fordham Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1205332905
  Medicare reassignment
• USA Vein Clinics of Connecticut PLLC

  • Vascular Surgery Physician
  • Stamford, CT
  • NPI 1245839869
  Medicare reassignment
• USA Vein Clinics of New Jersey LLC

  • Specialist
  • Tinton Falls, NJ
  • NPI 1245663236
  Medicare reassignment
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1851468987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000",
            "fax_number": "417-328-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W PARKVIEW ST",
            "address_2": "SUITE 1G",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138279",
            "telephone_number": "417-326-8700",
            "fax_number": "417-328-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "MARTIN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2001010358",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "2001010358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263006",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020049033",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245315106",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamila Michelle Truitt, RPH, PHARMD
• Tweedie Chiropractic LLC
• John Telfer Tweedie III, DC
• Nicole Marie Twenter, LPC
• Joanna Duane Twombly, D.O.
• Upon the Rock, Inc.
• Kyla Van Black
• Laura C Vance, M.D.
• Ronald L Vance, M.D.
• Amber Vande Linde, D.C.

• Surgery Physician in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.