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TYLER MATTHEW PECKHAM
NPI 1013423367
Counselor - Mental Health in Beavercreek, OH

Active since December 22, 2017PECOS EnrolledAccepts Medicare Assignment
3359 KEMP RD STE 200, BEAVERCREEK, OH 45431(937) 490-2090(937) 490-2780 Get Directions Write a Review

NPPES record last updated: October 3, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 26, 2025, Dec 22, 2017 (2 updates tracked since 2017).

About Tyler Matthew Peckham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER MATTHEW PECKHAM (NPI 1013423367) is an individual mental health provider in Beavercreek, Ohio, licensed in Ohio (E.2505064) and active in the NPI registry since December 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Troy, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1013423367
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameTYLER MATTHEW PECKHAM
Location Address3359 KEMP RD STE 200Beavercreek, OH 45431-2567
Mailing Address303 W Ross StTroy, OH 45373-3931 · (937) 216-9282
Phone(937) 490-2090
Fax(937) 490-2780
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 22, 2017
Last NPPES UpdateOctober 3, 20252 updates tracked since enumeration
NPPES CertifiedOctober 3, 2025
✔ NPI 1013423367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OH · E.2505064
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
3359 KEMP RD STE 200, Beavercreek, OH 45431
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Secondary Practice Location 1

Location 1303 W Ross StTroy, OH 45373-3931 · Phone (937) 216-9282

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tyler Matthew Peckham is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365962529
PECOS Enrollment IDI20250219001193
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Tyler Peckham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Samaritan Behavioral Health, Inc.
10.0 mi
Clinic/Center
601 S EDWIN C MOSES BLVD, FIRST FLOOR, NW BUILDING
Dayton, OH 45417
  • Reassigned Medicare billing, Ohio enrollment
  • 100 clinicians in this Medicare group
NPI 1205888641 (937) 224-1694
Kettering Independent Medical Group Inc
12 mi
Orthopaedic Surgery
1 PRESTIGE PL, SUITE 910
Miamisburg, OH 45342
  • Reassigned Medicare billing, Ohio enrollment
  • 984 clinicians in this Medicare group
NPI 1629387865 (937) 762-1629

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Peckham's NPI number?

The NPI number for Tyler Peckham is 1013423367. It was assigned to this individual provider in the NPPES registry on December 22, 2017.

Where is Tyler Peckham located?

Tyler Peckham practices at 3359 Kemp Rd Ste 200, Beavercreek, OH 45431. The listed phone number is (937) 490-2090.

What is Tyler Peckham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Tyler Peckham enrolled in Medicare?

Yes. Tyler Peckham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Tyler Peckham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Peckham reassigns Medicare benefits to 2 organizations: Samaritan Behavioral Health, Inc. (Dayton, OH) and Kettering Independent Medical Group Inc (Miamisburg, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tyler Peckham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tyler Peckham accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 2 other insurers list Tyler Peckham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tyler Peckham was last updated on October 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.