Dr Tyler J Koivisto, DDS in White Bear Lake, MN

Dr Tyler J Koivisto, DDS is a medicare enrolled "Dentist" provider in White Bear Lake, Minnesota. His current practice location is 1430 Highway 96, White Bear Lake, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 426-9502.

Dr Tyler J Koivisto is licensed to practice in Minnesota (license number D13236) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588002430.

Contact Information

	Dr Tyler J Koivisto, DDS
	1430 Highway 96, White Bear Lake, MN 55110
	(651) 426-9502
	(651) 653-2158

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Tyler J Koivisto
Gender	Male
Speciality	Dentist
Location	1430 Highway 96, White Bear Lake, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588002430
Provider Enumeration Date: 06/12/2013
Last Update Date: 07/21/2022

Medicare PECOS Information:

PECOS PAC ID: 8224313879
Enrollment ID: I20170321002406

Medical Identifiers

Medical identifiers for Dr Tyler J Koivisto such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588002430	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	D13236 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tyler J Koivisto allows following entities to bill medicare on his behalf.

Entity Name	Group Health Plan Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tyler J Koivisto is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Tyler J Koivisto, DDS 1430 Highway 96, White Bear Lake, MN 55110 Ph: (651) 426-9502	Dr Tyler J Koivisto, DDS 1430 Highway 96, White Bear Lake, MN 55110 Ph: (651) 426-9502

Reviews and Comments

Dentist in White Bear Lake, MN

Dr. Thomas E Grzeskowiak, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1430 Highway 96, White Bear Lake, MN 55110 Phone: 651-426-9502 Fax: 651-653-2158
Dr. Charles Francis Kaminski Jr., DDS Dentist Medicare: Medicare Enrolled Practice Location: 4754 Washington Square, White Bear Lake, MN 55110 Phone: 651-426-9499 Fax: 651-429-6255
Scott Arthur Kron, DDS Dentist Medicare: Medicare Enrolled Practice Location: 4706 Banning Ave, White Bear Lake, MN 55110 Phone: 651-429-3348 Fax: 651-429-3945
Dr. Kent C Gulden, D.D.S. P.A. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4437 Lake Ave S, White Bear Lake, MN 55110 Phone: 651-429-5265 Fax: 651-429-9630
Dr. Olga Ivett Castro, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 4801 Highway 61 N Ste 200, White Bear Lake, MN 55110 Phone: 651-429-3535
Jordan Dittberner, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4700 White Bear Pkwy, White Bear Lake, MN 55110 Phone: 651-762-7677
Dr. Wendy L. Sydlewski, DDS, MD. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2126 5th St, White Bear Lake, MN 55110 Phone: 651-426-9986

Dr Tyler J Koivisto, DDS - Medicare Dentist in White Bear Lake, MN