TYLER RODERICKS (DPM) – Student in an Organized Health Care Education/Training Program, NPI 1760045447
Student in an Organized Health Care Education/Training Program
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
386 PODIATRY in MA
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Provider Addresses for TYLER RODERICKS (DPM)
1642 HUSTED AVE
SAN JOSE, CA 951255040
Phone: (408) 693-1999
Type: Mailing
Mount Auburn Hospital, 330, Mount Auburn Street, Coolidge Hill, Cambridge, Middlesex County, Massachusetts, 02138, United States
CAMBRIDGE, MA 021385502
Phone: (617) 492-3500
Type: Location
27 ASHLAND ST
WATERTOWN, MA 024722920
Phone: (408) 693-1999
Type: Mailing
12416 66TH ST STE A
LARGO, FL 337733430
Phone: (727) 547-4700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $2,696.
Total Amount is formed as General ($2,696) + Research ($0) + Ownership ($0) = $2,696.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: TriMed, Inc. ($1,340).
Total Amount
$2,696
General + Research + Ownership
Payments
30
Total payment records
General Amount
$2,696
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| TriMed, Inc. | $1,340 |
| Arthrex, Inc. | $891 |
| Stryker Corporation | $303 |
| Invictus Surgical Incorporated | $82 |
| DePuy Synthes Sales Inc. | $33 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230612002991 | I | Podiatry | FL | TBD |
| I20240709004570 | I | Podiatry | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95125)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | KY | |
| P O D I A T R Y | WA |
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