TYLER PENDER MD
NPI 1053846469
Surgery in Salt Lake City, UT
About Tyler Pender Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYLER PENDER MD (NPI 1053846469) is an individual surgery provider in Salt Lake City, Utah, licensed in Utah (10964118-1205) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Sanford Medical Center Fargo, and is a graduate of Loma Linda University School Of Medicine (2017).
NPPES Registry Identity
Specialties & Licenses 2
Accepted 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 Pender Md 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.
Medicare Billing Reassignments
5Medicare enrollment records show Tyler Pender reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 clinicians in this Medicare group
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 338 clinicians in this Medicare group
Ellendale, ND 58436
- Reassigned Medicare billing, North Dakota enrollment
- 1,464 clinicians in this Medicare group
Grand Forks, ND 58201
- Reassigned Medicare billing, North Dakota enrollment
- 701 clinicians in this Medicare group
Madison, WI 53715
- Reassigned Medicare billing, Wisconsin enrollment
- 1,377 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Sanford Medical Center Fargo
Acute Care Hospitals · Fargo, NDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALT LAKE CITY, UT 84132
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 Pender's NPI number?
The NPI number for Tyler Pender is 1053846469. It was assigned to this individual provider in the NPPES registry on April 23, 2017.
Where is Tyler Pender located?
Tyler Pender practices at 50 N Medical Dr, Salt Lake City, UT 84132. The listed phone number is (801) 581-2121.
What is Tyler Pender's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Tyler Pender enrolled in Medicare?
Yes. Tyler Pender 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 Pender's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Pender reassigns Medicare benefits to 5 organizations: University Of Utah Adult Services (Salt Lake City, UT), University Of Utah Acuity Care Services (Salt Lake City, UT), Sanford Medical Center Fargo (Ellendale, ND), Altru Health System (Grand Forks, ND) and Dean Health Systems, Inc (Madison, WI). 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 Pender's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tyler Pender accept?
Health plans from Blue Cross Blue Shield of North Dakota, Molina Healthcare and Sanford Health Plan list Tyler Pender 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.
Is Tyler Pender affiliated with any hospitals?
According to CMS data, Tyler Pender is affiliated with Sanford Medical Center Fargo.
When was this NPI record last updated?
The NPPES record for Tyler Pender was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Tyler Pender, MD · NPI 1053846469
Surgery physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since April 23, 2017.
## Identity
- **NPI:** 1053846469 (Entity type: Individual)
- **Enumerated:** April 23, 2017
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 10964118-1205 (Utah)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 50 N MEDICAL DR, Salt Lake City, UT 84132-0001
- **Phone:** (801) 581-2121
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): University Of Utah Adult Services (NPI 1093119893, Salt Lake City, UT); University Of Utah Acuity Care Services (NPI 1407250541, Salt Lake City, UT); Sanford Medical Center Fargo (NPI 1346256682, Ellendale, ND); Altru Health System (NPI 1043309552, Grand Forks, ND); Dean Health Systems, Inc (NPI 1053358846, Madison, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Loma Linda University School Of Medicine, class of 2017
## Record status
- **NPPES last updated:** July 22, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1053846469) · Data from the CMS NPPES public registry.