TYLER O STUTZMAN PA-C
NPI 1124448964
Physician Assistant in Salem, OR

Q: What is Tyler Stutzman's NPI number?

The NPI number for Tyler Stutzman is 1124448964. It was assigned to this individual provider in the NPPES registry on April 20, 2014.

Q: What is Tyler Stutzman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Stutzman was last updated on June 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 20, 2014PECOS Enrolled

890 OAK ST SE BLDG A, SALEM, OR 97301(503) 814-1280(503) 814-1070 Get Directions Write a Review

NPPES record last updated: June 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 15, 2025, Aug 12, 2024, Jun 17, 2021 and 1 more (4 updates tracked since 2018).

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About Tyler O Stutzman Pa-c NPPES

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

TYLER O STUTZMAN PA-C (NPI 1124448964) is an individual physician assistant in Salem, Oregon, licensed in Virginia (0110005595) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Goodfellow Afb.

NPPES Registry Identity

NPI1124448964

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameTYLER O STUTZMANCredential: PA-C

Location Address890 OAK ST SE BLDG ASalem, OR 97301-3905

Mailing Address271 Fort Richardson AveGoodfellow Afb, TX 76908-4901 · (325) 654-3677

Phone(503) 814-1280

Fax(503) 814-1070

Sole ProprietorNo

Enumeration DateApril 20, 2014

Last NPPES UpdateJune 15, 20254 updates tracked since enumeration

NPPES CertifiedJune 15, 2025

✔ NPI 1124448964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in VA · 0110005595✔ Licensed in OR · PA225085

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

890 OAK ST SE BLDG A, Salem, OR 97301

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Secondary Practice Location 1

Location 1271 Fort Richardson AveGoodfellow AFB, TX 76908-4901 · Phone (325) 654-3677

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler O Stutzman Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97301 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

Most-billed visit code 99213

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

Other Providers at the Same Location NPPES 19

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

MR. CHRISTOPHER MICHAEL SIMPSON PA

Physician Assistant