Individual provider Active NPI

Tyler Carry Warmack

  • Surgery Physician
  • Appleton, WI
National Provider Identifier
1932697307
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
83204 Issued in WI
Practice address
1501 S Madison St
Appleton, WI 54915-1846
Phone
(920) 738-2000
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 239436 NC
Surgery Physician 208600000X 83204 WI Primary

Addresses

Primary practice location

1501 S Madison St
Appleton, WI 54915-1846

Mailing address

2108 Markham Dr
Chapel Hill, NC 27514-2123

Other practice location 1

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Other identifiers 1

IdentifierTypeStateIssuer
100280513MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240711001923 WI Practitioner - General Surgery 3274888102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
North Carolina Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239436NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Calumet Hospital, Inc CurrentSince Feb 8, 2026 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 27, 2024 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 27, 2024 Accepting new patients

Locations

1531 S Madison St
Appleton, WI 54915
Phone (920) 730-4411

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

1550 Midway Pl
Menasha, WI 54952
Phone (920) 727-8030

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

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 2

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1932697307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 MARKHAM DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151846",
            "telephone_number": "920-738-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "984-974-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARMACK",
        "first_name": "TYLER",
        "middle_name": "CARRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "239436",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "83204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100280513",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.