DR. TYLER HUMPHREY (MD) – Emergency Medicine Physician, NPI 1467980102
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. TYLER HUMPHREY (MD)
419 S Coral St
Kalkaska, MI 496462503
Phone: (231) 258-7506
Fax: (231) 258-7592
Type: Location
Advocate Children's Hospital, 4440, West 95th Street, Oak Lawn, Worth Township, Cook County, Illinois, 60453, United States
OAK LAWN, IL 604532600
Phone: (708) 684-5375
Type: Mailing
1105 SIXTH ST
TRAVERSE CITY, MI 496842345
Phone: (231) 935-5000
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: MY01 Inc. ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MY01 Inc. | $23 |
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: 2021-06-30
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 |
|---|---|---|---|---|
| I20200729000976 | I | Emergency Medicine | CA | TBD |
| I20210630003521 | I | Emergency Medicine | MI | 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 49646)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | OH | |
| Emergency Medicine | MI | |
| Emergency Medicine | OH | |
| Emergency Medicine | CA | |
| - | DE | |
| Emergency Medicine | CA | |
| Emergency Medicine | CA | |
| - | CA | |
| Emergency Medicine | CA | |
| Emergency Medicine | NY |
Reviews
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