TYLER BOSSHART – Physical Therapist, NPI 1811440134

TYLER BOSSHART is a healthcare provider. based in Bloomer, Wisconsin. specializing in Physical Therapist. They hold a License No. 13457 (WI). The NPI Number for TYLER BOSSHART is 1811440134

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
TYLER BOSSHART
NPI
1811440134
Phone
(715) 568-4669
Address
1731 17TH AVE
Enumeration Date
3 August 2016
Last Update Date
3 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7155684669
Graduation Year
2016 (10 years ago)
PAC ID
8628349024
Group Practice PAC ID
3375518202
Professional Enrollment ID
I20170803001020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for TYLER BOSSHART

  • 1731, 17th Avenue, Bloomer, Chippewa County, Wisconsin, 54724, United States

    BLOOMER, WI 547241512

    Phone: (715) 568-4669

    Fax: (715) 568-4673

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2017-08-03

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170803001020IPhysical Therapist In Private PracticeWITBD

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.

Verify on CMS Revalidation Lookup Tool

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 54724)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375518202View full group profile
NameSpecialtyState
-WI
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
Occupational Therapist In Private PracticeWI
Physical Therapist In Private PracticeWI
-WI
-WI

Reviews

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Frequently asked questions

What NPI should I save for TYLER BOSSHART?
Save NPI 1811440134 if you need a stable reference for TYLER BOSSHART.
Is TYLER BOSSHART currently active in the NPI registry?
CMS-published data lists TYLER BOSSHART as an active registrant.
What field does TYLER BOSSHART work in?
You can think of TYLER BOSSHART as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is TYLER BOSSHART's primary listing?
We display Bloomer, Wisconsin because that is what the record indicates for TYLER BOSSHART.
Is TYLER BOSSHART a real provider?
This page reflects official NPPES data for NPI 1811440134. Always confirm identity and privileges with the practice and licensing boards.

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