Sam Tilden Tyson, MD is a medicare enrolled "Internal Medicine" physician in Canutillo, Texas. He went to University Of Arkansas College Of Medicine and graduated in 1984 and has 40 years of diverse experience with area of expertise as General Practice. His current practice location is
6898 Doniphan Dr, Canutillo, Texas. You can reach out to his office (for appointments etc.) via phone at
(915) 877-3151.
Sam Tilden Tyson is licensed to practice in Texas (license number H2185) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1659323848.
Physician's Profile
| Full Name | Sam Tilden Tyson |
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| Gender | Male |
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| Speciality | General Practice |
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| Experience | 40 Years |
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| Location | 6898 Doniphan Dr, Canutillo, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Sam Tilden Tyson attended and graduated from University Of Arkansas College Of Medicine in 1984
NPI Data:
- NPI Number: 1659323848
- Provider Enumeration Date: 05/16/2006
- Last Update Date: 09/10/2020
Medicare PECOS Information:
- PECOS PAC ID: 8426351461
- Enrollment ID: I20201026000462
Medical Identifiers
Medical identifiers for Sam Tilden Tyson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659323848 | NPI | - | NPPES |
| 1383929-10 | Medicaid | PA | |
| 1383929-07 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | H2185 (Texas) | Secondary |
| 208D00000X | General Practice | H2185 (Texas) | Secondary |
| 207R00000X | Internal Medicine | H2185 (Texas) | Primary |
Medical Facilities Affiliation
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. Sam Tilden Tyson allows following entities to bill medicare on his behalf.
| Entity Name | West Valley Clinic, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003186248
PECOS PAC ID: 0840610143
Enrollment ID: O20201026000352 |
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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. Sam Tilden Tyson 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 |
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Sam Tilden Tyson, MD
7231 Hunters Ridge Dr,
Dallas, TX 75248-5207
Ph: (915) 877-3151 | Sam Tilden Tyson, MD
6898 Doniphan Dr,
Canutillo, TX 79835-5401
Ph: (915) 877-3151 |
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