DR. TYLER DANIEL PETERSEN D.O.
NPI 1093102220
Orthopaedic Surgery - Orthopaedic Trauma in Vancouver, WA

Q: What is Tyler Petersen's NPI number?

The NPI number for Tyler Petersen is 1093102220. It was assigned to this individual provider in the NPPES registry on April 26, 2015.

Q: What is Tyler Petersen's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Petersen was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since April 26, 2015PECOS EnrolledAccepts Medicare Assignment

77.5/100

CMS Quality Rating

200 NE MOTHER JOSEPH PL STE 110, VANCOUVER, WA 98664(360) 254-6161(360) 803-0847 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 21, 2025, Aug 27, 2022, Apr 25, 2017 (3 updates tracked since 2017).

On this page

About Dr. Tyler Daniel Petersen D.o. NPPES

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

DR. TYLER DANIEL PETERSEN D.O. (NPI 1093102220) is an individual orthopaedic trauma provider in Vancouver, Washington, licensed in Washington (OP61629112) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Peacehealth Southwest Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1093102220

Entity TypeIndividualMale

Primary Taxonomy207XX0801X

Provider Legal NameDR. TYLER DANIEL PETERSENCredential: D.O.

Location Address200 NE MOTHER JOSEPH PL STE 110Vancouver, WA 98664-3293

Mailing Address200 Ne Mother Joseph Pl Ste 210Vancouver, WA 98664-3295 · (360) 254-6161 · Fax (360) 803-0847

Phone(360) 254-6161

Fax(360) 803-0847

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateApril 26, 2015

Last NPPES UpdateNovember 21, 20253 updates tracked since enumeration

NPPES CertifiedNovember 21, 2025

✔ NPI 1093102220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians

Taxonomy Code207XX0801X

License✔ Licensed in WA · OP61629112

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.

200 NE MOTHER JOSEPH PL STE 110, Vancouver, WA 98664

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tyler Daniel Petersen D.o. 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 ID9436429032

PECOS Enrollment IDI20220802002994, I20250325003278

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

64 services43 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

44 services44 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Peacehealth Southwest Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500050

Location400 NE Mother Joseph PlaceVancouver, WA 98668 · Clark County

Emergency services Birthing friendly

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.

77.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.61

Promoting Interoperability

100

Improvement Activities

Cost

56.4

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.

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