TYLER KALMUCK D.D.S.
NPI 1063869485
Dentist - Oral and Maxillofacial Surgery in Sheboygan, WI
NPI Status: Active since May 16, 2016
Contact Information
3637 WILGUS AVE
SHEBOYGAN, WI
ZIP 53081
Phone: (920) 458-8213
Fax: (920) 459-9797
- Individual
- Male
- Dentist
- Oral and Maxillofacial Surgery
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About TYLER KALMUCK
This page provides the complete NPI Profile along with additional information for Tyler Kalmuck, a provider established in Sheboygan, Wisconsin with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1063869485 assigned on May 2016. The practitioner's primary taxonomy code is 1223S0112X with license number 1002255-15 (WI). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1063869485
- Provider Name
- TYLER KALMUCK D.D.S.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3637 WILGUS AVE SHEBOYGAN, WI 53081
- Location Phone
- (920) 458-8213
- Location Fax
- (920) 459-9797
- Mailing Address
- 3637 WILGUS AVE SHEBOYGAN, WI 53081
- Mailing Phone
- (920) 458-8213
- Mailing Fax
- (920) 459-9797
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-16-2016
- Last Update Date
- 09-21-2020
- Code Navigator
A dentist like Tyler Kalmuck is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Tyler Kalmuck opted out of Medicare effective on 01-01-2023 until 01-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 1002255-15
- License State
- WI
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Prevea360 Bronze HSA - HMO
- Prevea360 Bronze Share - HMO
- Prevea360 Catastrophic - HMO
- Prevea360 Expanded Bronze Standard - HMO
- Prevea360 Gold HSA - HMO
- Prevea360 Gold Share - HMO
- Prevea360 Gold Standard - HMO
- Prevea360 Silver $0 Copay PCP Visits - HMO
- Prevea360 Silver Share - HMO
- Prevea360 Silver Standard - HMO
- Delta Dental Individual and Family High Plan - PPO
- Delta Dental Individual and Family Low Plan - PPO
- Delta Dental Individual and Family Low Plan Major - PPO
- Delta Dental PPO Plus Premier Family Plan High Option - PPO
- Delta Dental PPO Plus Premier Family Plan Low Option - PPO
- Guardian Basics for Families and Individuals - PPO
- Guardian Essentials for Families and Individuals - PPO
- Guardian Preventive Plus for Families and Individuals - PPO
- Guardian Select for Families and Individuals - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold Essential + 3Free PCP Visits - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + 3 Free PCP Visits - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Signature Prestige Bronze $0 Deductible - HMO
- Signature Prestige Bronze $0 Deductible + Dental + Vision - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Tyler Kalmuck is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2023
Opt-Out End Date: 01-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 53081 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.37
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $16.84
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 6 | 3 | 8 | 6 | 9 | 4 | 8 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 12 | 3 | 16 | 6 | 18 | 4 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 2 + 3 + 1 + 6 + 6 + 1 + 8 + 4 + 1 + 6 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1063869485 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063869485, enumerated in the NPI registry as an "individual" on May 16, 2016
The provider is located at 3637 Wilgus Ave Sheboygan, Wi 53081 and the phone number is (920) 458-8213
The provider's speciality is Dentist with taxonomy code 1223S0112X with a focus in Oral and Maxillofacial Surgery
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on January 01, 2023 to opt-out of the Medicare program. The provider is excluded from the Medicare program until January 01, 2027.
This NPI record was last updated on May 16, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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