Tyler Jon Gardner, is a medicare enrolled "Orthopaedic Surgery" physician in Greendale, Indiana. His current practice location is
1600 Flossie Dr, Greendale, Indiana. You can reach out to his office (for appointments etc.) via phone at
(859) 301-2663.
Tyler Jon Gardner is licensed to practice in Indiana (license number 01096563A) 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 1124589700.
Physician's Profile
| Full Name | Tyler Jon Gardner |
|---|
| Gender | Male |
|---|
| Speciality | Orthopaedic Surgery |
|---|
| Location | 1600 Flossie Dr, Greendale, Indiana |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1124589700
- Provider Enumeration Date: 03/27/2019
- Last Update Date: 06/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 0446585509
- Enrollment ID: I20250505002291
Medical Identifiers
Medical identifiers for Tyler Jon Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124589700 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | 60953 (Kentucky) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207X00000X | Orthopaedic Surgery | 01096563A (Indiana) | 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. Tyler Jon Gardner allows following entities to bill medicare on his behalf.
| Entity Name | Orthocincy Orthopaedics & Sports Medicine Psc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1598714560
PECOS PAC ID: 3173500196
Enrollment ID: O20040707000498 |
|---|
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. Tyler Jon Gardner 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 |
|---|
Tyler Jon Gardner,
560 S Loop Rd,
Edgewood, KY 41017-3405
Ph: (859) 301-2663 | Tyler Jon Gardner,
1600 Flossie Dr,
Greendale, IN 47025-8424
Ph: (859) 301-2663 |
Reviews and Comments