Individual provider Active NPI

Tyler Ernest Patrick, DO

  • Otolaryngology Physician
  • Ellsworth, ME
National Provider Identifier
1932600145
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
DO3615 Issued in ME
Practice address
50 Union Street
Ellsworth, ME 04605-2119
Phone
(072) 664-5658
NPI assigned
Feb 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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 DO3615 ME Primary

Addresses

Primary practice location

50 Union Street
Ellsworth, ME 04605-2119

Mailing address

1170 Shore Road
Lamoine, ME 04605
Phone (603) 978-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20230804003152 ME Practitioner - Otolaryngology 8224393020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

50 Union St
Ellsworth, ME 04605-1534

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
71.71
Promoting interoperability
100
Improvement activities
40
Cost
69.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Coast Regional Health Facilities CurrentSince Aug 13, 2023 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Aug 13, 2023 Accepting new patients

Locations

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

50 Union St
Ste 1100
Ellsworth, ME 04605
Phone (207) 664-5658

Interoperability endpoints

  • Direct secure messaging: tpatrick2364995@direct.trinity-health.org

Organizations & group practices 2

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 5

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1932600145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 SHORE ROAD",
            "city": "LAMOINE",
            "state": "ME",
            "postal_code": "04605",
            "telephone_number": "603-978-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 UNION STREET",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052119",
            "telephone_number": "072-664-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "TYLER",
        "middle_name": "ERNEST",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "DO3615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.