DR. MARTIN S. TYSON (DO) – Surgery Physician, NPI 1851468987
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
787 GENERAL SURGERY in MO
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Provider Addresses for DR. MARTIN S. TYSON (DO)
Citizens Memorial Hospital, 1500, North Oakland Avenue, Bolivar, Polk County, Missouri, 65613, United States
BOLIVAR, MO 656133011
Phone: (417) 326-6000
Fax: (417) 328-6338
Type: Mailing
1155, West Parkview Street, Bolivar, Polk County, Missouri, 65613, United States
SUITE 1G
BOLIVAR, MO 656138279
Phone: (417) 326-8700
Fax: (417) 328-6755
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $87.
Total Amount is formed as General ($87) + Research ($0) + Ownership ($0) = $87.
Last reported payment date: 2023-01-31 • Largest payer in this snapshot: Kerecis Limited ($67).
Total Amount
$87
General + Research + Ownership
Payments
2
Total payment records
General Amount
$87
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $67 |
| Smith+Nephew, Inc. | $21 |
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: 2023-06-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20230425001199 | I | General Surgery | CT | TBD |
| I20230503001342 | I | General Surgery | NY | TBD |
| I20230609001429 | I | General Surgery | NJ | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 26 | $0 |
Insurance plans in this area (ZIP 65613)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | MO | 11042 | Removal of skin and tissue first 20 sq cm or less | 66 | 34 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Practice | NY | |
| Internal Medicine, Emergency Medicine | KY | |
| General Surgery | NY | |
| Thoracic Surgery | ID | |
| Cardiovascular Disease (Cardiology) | NY | |
| General Surgery | NY | |
| Interventional Radiology, Diagnostic Radiology | NY |
Reviews
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