TYLER VANADURONGVAN MD
NPI 1972173524
Family Medicine in Sioux City, IA

Q: What is Tyler Vanadurongvan's NPI number?

The NPI number for Tyler Vanadurongvan is 1972173524. It was assigned to this individual provider in the NPPES registry on June 27, 2021.

Q: What is Tyler Vanadurongvan's specialty?

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

Active since June 27, 2021PECOS Enrolled

2501 PIERCE ST, SIOUX CITY, IA 51104(712) 294-5000 Get Directions Write a Review

NPPES record last updated: June 27, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tyler Vanadurongvan Md NPPES

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

TYLER VANADURONGVAN MD (NPI 1972173524) is an individual family medicine provider in Sioux City, Iowa, licensed in Iowa (R-12297) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972173524

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTYLER VANADURONGVANCredential: MD

Location Address2501 PIERCE STSioux City, IA 51104-3725

Mailing Address700 4th St Apt 504Sioux City, IA 51101-1702 · (612) 239-3938

Phone(712) 294-5000

Sole ProprietorYes

Enumeration DateJune 27, 2021

NPPES CertifiedJune 27, 2021

✔ NPI 1972173524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IA · R-12297

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.

2501 PIERCE ST, Sioux City, IA 51104

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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 Vanadurongvan Md 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 51104 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

$81.84 typical visit price

range $52.96 – $161.40

Typical copayment $20.46 (range $13.24 – $40.35)

Most-billed visit code 99203

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $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.

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.

KORNELIA KELLOGG D.O.

Family Medicine