NPIMap

Individual provider Active NPI

Tyler James Willman, M.D.

  • Otolaryngology Physician
  • Dubuque, IA
National Provider Identifier
1912393687
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
47080 Issued in IA
Practice address
1000 Langworthy St
Dubuque, IA 52001-7365
Phone
(563) 584-3475
Fax
(563) 584-3395
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 47080 IA Primary

Addresses

Primary practice location

1000 Langworthy St
Dubuque, IA 52001-7365

Mailing address

1000 Langworthy St
Dubuque, IA 52001-7365
Phone (563) 584-3475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200617002703 IA Practitioner - Otolaryngology 4688987126 Reassigns benefits to 2 organizations
I20210104001121 WI Practitioner - Otolaryngology 4688987126 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians
Mercy Specialty ClinicGroup PAC ID 3375639586, 65 clinicians
Unified Therapy Services, IncGroup PAC ID 7618985714, 124 clinicians

Practice addresses (Care Compare)

1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100

1410 N 4TH St
Clinton, IA 52732-2940
Phone (563) 244-5900

4135 Pennsylvania Ave
Dubuque, IA 52002-2628

600 14TH Ave N
Clinton, IA 52732-2914

915 13TH Ave N
Mercyone Clinton Plaza
Clinton, IA 52732-5067
Phone (563) 243-2511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision152
Removal of tissue1-10
Removal of skin lesions57
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47080IAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health Inc Current Accepting new patients
Medical Associates of Clinton, Iowa P.L.C. Current Accepting new patients
Upland Hills Health, Inc CurrentSince May 1, 2023 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Nov 20, 2020 Accepting new patients
Medical Associates Clinic P C CurrentSince Jun 29, 2020 Accepting new patients
Mercy Specialty Clinic CurrentSince Oct 1, 2020 Accepting new patients
Prairie Du Chien Memorial Hospital Assoc Inc CurrentSince Nov 20, 2020 Accepting new patients
Mercy Specialty Clinic CurrentSince Oct 1, 2020 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc Past Accepting new patients

Locations

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

1410 N 4th St
Clinton, IA 52732
Phone (563) 244-5555

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

Interoperability endpoints

  • Direct secure messaging: twilliam450978@direct-ehr-ssmhc.com
  • Direct secure messaging: twillman733375@direct.emplifyhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 10

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1912393687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017365",
            "telephone_number": "563-584-3475",
            "fax_number": "563-584-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LANGWORTHY ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017365",
            "telephone_number": "563-584-3475",
            "fax_number": "563-584-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "47080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.