Individual provider Active NPI

Tyler Anthony Wieman

  • Family Medicine Physician
  • Westminster, CO
National Provider Identifier
1922687342
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0069780 Issued in CO
Practice address
14300 Orchard Pkwy FL 1
Westminster, CO 80023-9206
Phone
(303) 430-5560
NPI assigned
Apr 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0069780 CO Primary

Addresses

Primary practice location

14300 Orchard Pkwy FL 1
Westminster, CO 80023-9206

Mailing address

14300 Orchard Pkwy FL 1
Westminster, CO 80023-9206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230106001192 CO Practitioner - Family Practice 6305240342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Aurora, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

2600 Campus Dr
Suite a
Lafayette, CO 80026-3358
Phone (303) 673-1900

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 23, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 23, 2024 Accepting new patients

Locations

2600 Campus Dr
Ste A
Lafayette, CO 80026
Phone (303) 665-1900

Organizations & group practices 3

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 1

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": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1922687342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 ORCHARD PKWY FL 1",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 ORCHARD PKWY FL 1",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239206",
            "telephone_number": "303-430-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMAN",
        "first_name": "TYLER",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-04",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0069780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.