Tyler W Johnson, DO in Coeur D Alene, ID

Tyler W Johnson, DO is a medicare enrolled "Surgery" physician in Coeur D Alene, Idaho. His current practice location is 700 W Ironwood Dr Ste 341, Coeur D Alene, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 625-5200.

Tyler W Johnson is licensed to practice in Idaho (license number 4971842) 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 1376034181.

Contact Information

	Tyler W Johnson, DO
	700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814-4404
	(208) 625-5200
	(208) 625-5201

Map and Direction

Physician's Profile

Full Name	Tyler W Johnson
Gender	Male
Speciality	Surgery
Location	700 W Ironwood Dr Ste 341, Coeur D Alene, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376034181
Provider Enumeration Date: 05/29/2018
Last Update Date: 07/23/2025

Medicare PECOS Information:

PECOS PAC ID: 0648524736
Enrollment ID: I20250505001797

Medical Identifiers

Medical identifiers for Tyler W Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376034181	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	4971842 (Idaho)	Primary
208600000X	Surgery	LL82173 (South Carolina)	Secondary

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 W Johnson allows following entities to bill medicare on his behalf.

Entity Name	Kootenai Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252

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 W Johnson 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 W Johnson, DO 101 E Wood St, Spartanburg, SC 29303-3040 Ph: (864) 560-6750	Tyler W Johnson, DO 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814-4404 Ph: (208) 625-5200

Reviews and Comments

Surgery Doctors in Coeur D Alene, ID

Dr. Lucas Aaron Anderson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-4000
Michael Thomas May, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814 Phone: 208-625-5200 Fax: 208-625-5201
Dr. Robert Sumner West, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3621 W Fairway Dr, Coeur D Alene, ID 83815 Phone: 208-765-0714 Fax: 209-664-8238
Dr. Edward Gerard Detar, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814 Phone: 208-625-5200 Fax: 208-625-5201
Dr. Marcus Jewell Torgenson, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814 Phone: 208-625-5200 Fax: 208-625-5201
Stephanie Rose Moline, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 130, Coeur D Alene, ID 83814 Phone: 208-625-4700 Fax: 208-625-4701
Benjamin Mandel, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5085 Fax: 208-625-5731

Tyler W Johnson, DO - Medicare Surgery in Coeur D Alene, ID