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Tyler O Stutzman , PA-C

Physician Assistant β€’ Salem, OR

Active NPI 1124448964 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

890 Oak St Se Bldg A
Salem, OR 973013905

Call 5038141280 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

890 Oak St Se Bldg A

Salem, OR 973013905

Telephone 5038141280
Fax 5038141070
Organization at the Same NPPES Address or Phone
17th Medgrp-Goodfellow Facility NPI 1104805142

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Goodfellow Afb, TX. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

University Of Nebraska College Of Medicine

Graduation Year

2015

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

11 years (graduated 2015)

CMS Doctors and Clinicians data list 2015 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Tyler Stutzman has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Tyler Stutzman as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Salem and Oregon

128 active clinicians are listed under Physician Assistant with a practice address in Salem, OR (2,095 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Salem

10.2% of these 128 clinicians have the CMS telehealth indicator.

75% of these 128 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-06-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES VA 0110005595

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES OR PA225085

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20250916002171

Enrollment State Jurisdiction

OR

PECOS Control ID

6709169253

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

271 Fort Richardson Ave

Goodfellow Afb, TX 769084901

Phone: 3256543677

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

13 listed
Dr. Michael Barra , MD

Emergency Medicine

NPI 1477672483

Doctor of Medicine (M.D.)

Dr. Scott Cruise , DO

Emergency Medicine

NPI 1265990139

Doctor of Osteopathic Medicine (D.O.)

Dr. Timothy Duenas , MD

Emergency Medicine

NPI 1154525970

Doctor of Medicine (M.D.)

Ryan Esparza , PHYSICIAN ASSISTANT

Physician Assistant - Medical

NPI 1902521503

PHYSICIANASSISTANT

Dr. Kyle Hoesterey , MD

Emergency Medicine

NPI 1588920375

Doctor of Medicine (M.D.)

Jared Houck

Emergency Medicine

NPI 1790104784

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

14 Historical Events
πŸ“
Updated Practice Location June 15, 2025

Registered at 890 OAK ST SE BLDG A, SALEM, OR 973013905 (Tel: 5038141280)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2025

Physician Assistant (license number reported to NPPES: OR PA225085)

πŸ“
Updated Practice Location August 12, 2024

Registered at 271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX 769084901 (Tel: 3256543677)

πŸ“
Updated Business Mailing Address August 12, 2024

Registered at 271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX 769084901 (Tel: 3256543677)

πŸ“
Updated Business Mailing Address June 17, 2021

Registered at 48TH MEDICAL GROUP RAF LAKENHEATH, UNIT 5115, APO, AE 094615115

πŸ“
Updated Practice Location March 20, 2018

Registered at 6311 RICHMOND HWY, ALEXANDRIA, VA 223066410 (Tel: 7036476087)

πŸ“
Updated Business Mailing Address March 20, 2018

Registered at 5000 COX RD, GLEN ALLEN, VA 230609263 (Tel: 8049685700)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 20, 2018

Physician Assistant (license number reported to NPPES: VA 0110005595)

βœ…
NPI Profile Active July 16, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 16, 2015

Registered at 238 BROOKLEY AVE SW, BOLLING AFB, DC 200327704 (Tel: 2024045512)

πŸ“
Business Mailing Address (Initial Record) July 16, 2015

Registered at 238 BROOKLEY AVE SW, BOLLING AFB, DC 200327704 (Tel: 2024045512)

πŸ‘€
Provider Name / Credentials (Initial Record) July 16, 2015

Recorded as TYLER STUTZMAN, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 16, 2015

Physician Assistant

🟒
Initial NPI Registration & Enumeration April 20, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1124448964
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 20, 2014
Last Update: June 15, 2025
Sole Proprietor: No

Other Physician Assistants in Salem

All Physician Assistants in Salem

Mailing Address

271 Fort Richardson Ave

Goodfellow Afb, TX 769084901

Phone: 3256543677

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.