TYLER ALLEN BRUNDRIDGE
NPI 1134715071
Nurse Practitioner in Edgewood, KY

Q: What is Tyler Brundridge's NPI number?

The NPI number for Tyler Brundridge is 1134715071. It was assigned to this individual provider in the NPPES registry on December 15, 2020.

Q: What is Tyler Brundridge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Brundridge was last updated on July 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 December 15, 2020PECOS EnrolledAccepts Medicare Assignment

90.38/100

CMS Quality Rating

1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017(859) 301-9010(859) 301-9018 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 24, 2023, Feb 11, 2021, Dec 15, 2020 (3 updates tracked since 2020).

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About Tyler Allen Brundridge NPPES

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

TYLER ALLEN BRUNDRIDGE (NPI 1134715071) is an individual nurse practitioner in Edgewood, Kentucky, licensed in Kentucky (3015580) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1134715071

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameTYLER ALLEN BRUNDRIDGE

Location Address1 MEDICAL VILLAGE DREdgewood, KY 41017-3403

Mailing Address1 Medical Village DrEdgewood, KY 41017-3403 · (859) 301-2000

Phone(859) 301-9010

Fax(859) 301-9018

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 15, 2020

Last NPPES UpdateJuly 24, 20233 updates tracked since enumeration

NPPES CertifiedJuly 24, 2023

✔ NPI 1134715071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in KY · 3015580

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License APRN.CNP.0028121 (OH), 3015580 (KY)

1 MEDICAL VILLAGE DR, Edgewood, KY 41017

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

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

Tyler Allen Brundridge 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 ID3476969734

PECOS Enrollment IDI20210310002962

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.

Hospital Affiliations CMS Care Compare

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

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

90.38/100

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

Scored through an Alternative Payment Model

Quality

80.76

Promoting Interoperability

100

Improvement Activities

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.

CARA LINDSAY HANSEN CRNA

Nurse Anesthetist, Certified Registered