NPIMap

Individual provider Active NPI

Tyler Drew Haden, MD

  • Urology Physician
  • Cape Girardeau, MO
National Provider Identifier
1972942035
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2018012019 Issued in MO
Practice address
3 Doctors Park
Cape Girardeau, MO 63703-4927
Phone
(573) 334-7748
Fax
(573) 334-5724
NPI assigned
Jun 21, 2013
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2013018114 MO
Urology Physician 208800000X 2018012019 MO Primary

Addresses

Primary practice location

3 Doctors Park
Cape Girardeau, MO 63703-4927

Mailing address

3 Doctors Park
Cape Girardeau, MO 63703-4927
Phone (573) 803-3592

Other practice location 1

University Of Missouri Department Of Surgery
McHaney Hall 413, DCO75.00
Columbia, MO 65212-0001
Phone (573) 884-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180625001701 MO Practitioner - Urology 7315181005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Girardeau Urology Associates IncGroup PAC ID 6608967716, 12 clinicians

Practice addresses (Care Compare)

3 Doctors Park
Cape Girardeau, MO 63703-4927
Phone (573) 334-7748

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.19 of 100Reported as group
Quality
66.37
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018012019MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Girardeau Urology Associates, Inc. Urology CurrentSince Aug 1, 2018 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-7748

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc06039_capegirardeauuroassoc
  • Direct secure messaging: tylerhaden@cgua.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1972942035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034927",
            "telephone_number": "573-803-3592",
            "fax_number": "573-334-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034927",
            "telephone_number": "573-334-7748",
            "fax_number": "573-334-5724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Missouri Department Of Surgery",
            "address_2": "McHaney Hall 413, DCO75.00",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-884-2000",
            "fax_number": "573-884-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADEN",
        "first_name": "TYLER",
        "middle_name": "DREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2013018114",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2018012019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.