TYLER JOSEPH SMITH PA-C
NPI 1295568723
Physician Assistant - Medical in Union Grove, WI
NPI Status: Active since August 21, 2024
- Individual
- Male
- Years of Experience 2
- Physician Assistant
- Medical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About TYLER SMITH
This page provides the complete NPI Profile along with additional information for Tyler Smith, a primary care provider established in Union Grove, Wisconsin with a medical specialization in Physician Assistant, focusing in medical and more than 2 years of experience. The healthcare provider is registered in the NPI registry with number 1295568723 assigned on August 2024. The practitioner's primary taxonomy code is 363AM0700X with license number 8089-23 (WI). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1295568723
- Provider Name
- TYLER JOSEPH SMITH PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1120 MAIN ST UNION GROVE, WI 53182
- Location Phone
- (262) 878-4424
- Mailing Address
- 1911 N EMMERTSEN RD MOUNT PLEASANT, WI 53406
- Medical School Name
- OTHER
- Graduation Year
- 2024
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-21-2024
- Last Update Date
- 08-21-2024
- Code Navigator
A primary care provider (PCP) like Tyler Smith sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
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
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 8089-23
- License State
- WI
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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 Smith is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Tyler Smith 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), a Home Health Agency (HHA) and Power Mobility Devices.
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
PECOS PAC ID: 5597206938
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240925001688
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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: Yes
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Tyler Smith is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
ASCENSION ALL SAINTS HOSPITAL | 3801 SPRING ST RACINE, WI 53405 | (262) 687-4011 | Acute Care Hospitals | |
ASCENSION SE WISCONSIN HOSPITAL | 5000 W CHAMBERS ST MILWAUKEE, WI 53210 | (414) 447-2130 | Acute Care Hospitals |
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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 | 2 | 9 | 5 | 5 | 6 | 8 | 7 | 2 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 18 | 5 | 10 | 6 | 16 | 7 | 4 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 1 + 8 + 5 + 1 + 0 + 6 + 1 + 6 + 7 + 4 + 24 = 67 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 67 = 3 | 3 |
The NPI number 1295568723 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1497779375 | LISA M. SIMONDS M.D. Individual | Family Medicine | 1120 MAIN ST UNION GROVE, WI 53182 (261) 878-4424 |
1821007683 | JODENE STROMMEN NP Individual | Nurse Practitioner | 1120 MAIN ST UNION GROVE, WI 53182 (262) 878-4424 |
1477888345 | AMANDA B STROM PA Individual | Physician Assistant (Medical) | 1120 MAIN ST UNION GROVE, WI 53182 (262) 878-4424 |
1912441569 | AMIE KOEHNLEIN LPC Individual | Counselor (Professional) | 1120 MAIN ST UNION GROVE, WI 53182 (262) 634-2391 |
1487680179 | MARY E BIENEMANN MD Individual | Family Medicine | 1120 MAIN ST UNION GROVE, WI 53182 (262) 878-4424 |
1881858157 | MRS. MARGARET E BAKER PA-C Individual | Physician Assistant | 1120 MAIN ST UNION GROVE, WI 53182 (262) 878-4424 |
1265894539 | LAURIE BETH POTRATZ Individual | Family Medicine | 1120 MAIN ST UNION GROVE, WI 53182 (262) 548-6903 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295568723, enumerated in the NPI registry as an "individual" on August 21, 2024
The provider is located at 1120 Main St Union Grove, Wi 53182 and the phone number is (262) 878-4424
The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical
The provider has more than 2 years of experience.
The provider might be accepting Accepts: Network Health. 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), a Home Health Agency (HHA) and Power Mobility Devices.
The practitioner is affiliated to the following hospital(s): ASCENSION ALL SAINTS HOSPITAL and ASCENSION SE WISCONSIN HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on August 21, 2024. 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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