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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. TYSON J ROETHLISBERGER D.D.S.
NPI 1487632949
Dentist - General Practice in Monroe, MI

Active since January 05, 2006PECOS Enrolled
721 N MACOMB ST, SUITE 3, MONROE, MI 48162(734) 241-6710(734) 241-6710 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Tyson J Roethlisberger D.d.s. NPPES

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

DR. TYSON J ROETHLISBERGER D.D.S. (NPI 1487632949) is an individual general practice provider in Monroe, Michigan, licensed in Michigan (2901015834) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487632949
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. TYSON J ROETHLISBERGERCredential: D.D.S.
Location Address721 N MACOMB ST, SUITE 3Monroe, MI 48162-2982
Mailing Address721 N Macomb St, Suite 3Monroe, MI 48162-2982 · (734) 241-6710 · Fax (734) 241-6710
Phone(734) 241-6710
Fax(734) 241-6710
Sole ProprietorNo
Enumeration DateJanuary 5, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1487632949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901015834
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
721 N MACOMB ST, Monroe, MI 48162
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Guardian.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)

Dr. Tyson J Roethlisberger D.d.s. 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 48162 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 4

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

ANDREA R RINKER DPM PC
Podiatrist (Foot & Ankle Surgery)
721 N MACOMB ST, SUITE 5
MONROE, MI 48162
Monroe County (734) 241-1222
PROGRESSIVE THERAPEUTIC HOME HEALTH CARE, INC.
Home Health
721 N MACOMB ST, SUITE 4
MONROE, MI 48162
Monroe County (734) 678-5275
GANESH RAMASWAMI M.D. P.C.
Specialist
721 N MACOMB ST, STE 6
MONROE, MI 48162
Monroe County (734) 299-3004
MICHIGAN HOME HOSPICE INC
Hospice Care, Community Based
721 N MACOMB ST
MONROE, MI 48162
Monroe County (734) 678-5275

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 Tyson Roethlisberger's NPI number?

The NPI number for Tyson Roethlisberger is 1487632949. It was assigned to this individual provider in the NPPES registry on January 5, 2006.

Where is Tyson Roethlisberger located?

Tyson Roethlisberger practices at 721 N Macomb St Suite 3, Monroe, MI 48162. The listed phone number is (734) 241-6710.

What is Tyson Roethlisberger's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Tyson Roethlisberger enrolled in Medicare?

Yes. Tyson Roethlisberger is registered in the Medicare PECOS enrollment system.

What insurance does Tyson Roethlisberger accept?

Health plans from Guardian list Tyson Roethlisberger 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.

When was this NPI record last updated?

The NPPES record for Tyson Roethlisberger was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.