Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TYLER JAMES MOON MD
NPI 1871120741
Orthopaedic Surgery in Saint Paul, MN

Q: What is Tyler Moon's NPI number?

The NPI number for Tyler Moon is 1871120741. It was assigned to this individual provider in the NPPES registry on March 23, 2020.

Q: What is Tyler Moon's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Moon was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since March 23, 2020PECOS Enrolled

640 JACKSON ST, SAINT PAUL, MN 55101(651) 254-2005(651) 254-1519 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 23, 2026, Jun 24, 2025, Mar 6, 2025 and 1 more (4 updates tracked since 2020).

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About Tyler James Moon Md NPPES

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

TYLER JAMES MOON MD (NPI 1871120741) is an individual orthopaedic surgery provider in Saint Paul, Minnesota, licensed in Minnesota (81869) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Houston, and is a graduate of Washington University School Of Medicine (2020).

NPPES Registry Identity

NPI1871120741

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameTYLER JAMES MOONCredential: MD

Location Address640 JACKSON STSaint Paul, MN 55101-2502

Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516

Phone(651) 254-2005

Fax(651) 254-1519

Sole ProprietorNo

Medical School CMSWashington University School Of MedicineGraduated 2020

Enumeration DateMarch 23, 2020

Last NPPES UpdateSeptember 23, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2026

✔ NPI 1871120741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in MN · 81869

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

640 JACKSON ST, Saint Paul, MN 55101

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Secondary Practice Location 1

Location 16431 Fannin St Ste Jjl 310Houston, TX 77030-1501 · Phone (314) 809-3938

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 James Moon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224469002

PECOS Enrollment IDI20260811001125

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 55101 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 20

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

WOJCIECH KRASZKIEWICZ M.D.

Internal Medicine