Tyler Carleton Lacy, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

14222027-1205 Issued in UT

Practice address

5295 S Commerce Dr Ste 550
Murray, UT 84107-4736

Phone

(801) 313-4110

NPI assigned

Apr 13, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, WA2 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

Specialty

Diagnostic Radiology

Education

Duke University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tellica Imaging - Washington LLCGroup PAC ID 0648757393, 50 clinicians

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007
• Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tlacy1101474@wm.providencedirect.org

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment Care Compare group NPD
• Tellica Imaging - Washington LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1346093150

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD (past)
• Tellica Imaging, LLC

  • Radiology Clinic/Center
  • Boise, ID
  • NPI 1760197198

  UT

  Medicare reassignment
• Ihc Health Services Inc

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1285019737
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Ogden, UT
  • NPI 1144802802
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • West Valley City, UT
  • NPI 1407438039
  NPD
• Tellica Imaging, LLC

  • Physiological Laboratory
  • Salt Lake City, UT
  • NPI 1649998709
  NPD
• Tellica Imaging - Washington LLC

  • Radiology Clinic/Center
  • Auburn, WA
  • NPI 1215887401

  Diagnostic Radiology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Sandy, UT
  • NPI 1962412486
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1861955049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 S COMMERCE DR STE 550",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074736",
            "telephone_number": "801-313-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "TYLER",
        "middle_name": "CARLETON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-13",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "14222027-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica La Bleu
• La Europa
• Michele L Laberee-Berg, OTR, CLT
• Laboratory Corporation of America
• Lactation Home Care
• Crystal Lafreniere
• Jessica Lagoo, RD
• Juana Lagunas
• Lacey Mae Lai, PA-C
• Jared R. Lake, M.D.

• Diagnostic Radiology Physician in Murray, UT
• Providers in Murray, UT by specialty
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.