Tyler Duckworth, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

74369 Issued in MN

Practice address

14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876

Phone

(763) 559-3779

NPI assigned

Jun 18, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tyler Klobucher Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Anesthesiology

Education

Mayo Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gillette Childrens Specialty Hospital Hospital, Saint Paul, MN, CCN 243300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427
  Medicare reassignment Care Compare group NPD

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

• Gillette Children'S Specialty Healthcare

  • Customized Equipment (DME)
  • Mankato, MN
  • NPI 1295145902

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1447352836
  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1477612604

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1730363698

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Burnsville, MN
  • NPI 1740349042

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1851450894

  Hospital

  Care Compare affiliation
• Gillette Childrens Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1760541700

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1861986457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474876",
            "telephone_number": "763-559-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474876",
            "telephone_number": "763-559-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "74369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "KLOBUCHER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ava Christine Drake
• Amanda Bailey Drees, PHARMD, RPH
• DRS Williams & Wimmer DDS PA
• Dillon Joseph Dryja, CRNA
• Lauren Lynn Ducklow, PA-C
• Justin Duda
• Hilay A Duff
• Matthew Dummer, MD
• Mary Kay Dunham
• Jessi Dvorak, DNP, APRN, CRNA

• Anesthesiology Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.