TYLER CLARK MD
NPI 1124414305
Family Medicine in Coeur D Alene, ID

Q: What is Tyler Clark's NPI number?

The NPI number for Tyler Clark is 1124414305. It was assigned to this individual provider in the NPPES registry on April 14, 2015.

Q: What is Tyler Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Clark was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 14, 2015PECOS EnrolledAccepts Medicare Assignment

94.91/100

CMS Quality Rating

1701 LINCOLN WAY, COEUR D ALENE, ID 83814(208) 625-4955(208) 625-4956 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 16, 2024, Nov 3, 2021, May 4, 2021 and 3 more (6 updates tracked since 2018).

On this page

About Tyler Clark Md NPPES

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

TYLER CLARK MD (NPI 1124414305) is an individual family medicine provider in Coeur D Alene, Idaho, licensed in Idaho (M-14362) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1124414305

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTYLER CLARKCredential: MD

Location Address1701 LINCOLN WAYCoeur D Alene, ID 83814-2537

Mailing Address2003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · (208) 625-4955 · Fax (208) 625-4956

Phone(208) 625-4955

Fax(208) 625-4956

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateApril 14, 2015

Last NPPES UpdateApril 16, 20246 updates tracked since enumeration

NPPES CertifiedApril 16, 2024

✔ NPI 1124414305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · M-14362

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1701 LINCOLN WAY, Coeur D Alene, ID 83814

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Moda Health Plan, Inc., Molina Healthcare 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 Clark 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.

PECOS PAC ID749592582

PECOS Enrollment IDI20181102001987

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

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

Kootenai Health, Inc.

0.3 mi

Psychiatry

2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814

Reassigned Medicare billing, Idaho enrollment
472 clinicians in this Medicare group

NPI 1174661151 (208) 625-4000

Kootenai Health, Inc.

0.3 mi

Psychiatry

2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814

Reassigned Medicare billing, Idaho enrollment
301 clinicians in this Medicare group

NPI 1174661151 (208) 625-4000

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

Areas of Expertise CMS Part B claims 8

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 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.

388 services209 patients

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.

314 services194 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

175 services175 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

31 services31 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

25 services25 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

20 services16 patients

Hospital Affiliations CMS Care Compare

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

94.91/100

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

Scored through an Alternative Payment Model

Quality

87.83

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers12 claims29 services$5.73 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers12 claims12 services$39.03 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers11 claims48 services$2.38 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

1 supplier11 claims11 services$23.32 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers23 claims23 services$86.05 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CATHERINE M SURIANO M.D.

Family Medicine