Tyler Jordan Mckinnon
MOUNTAIN WEST DERM - BLACKHART PLLC


Address: 271 Duffers Ln, Cascade, ID 83611-5506
Phone: 2089394599

Tyler Jordan Mckinnon (NPI# 1790131480, PAC ID# 7416237359) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.

Physician Overview

Nation Provider ID (NPI) 1790131480
PAC ID by PECOS 7416237359
Professional Enrollment ID I20161209001580
Full Name Tyler Jordan Mckinnon
Organization Legal Name MOUNTAIN WEST DERM - BLACKHART PLLC
Address 271 Duffers Ln
Cascade
ID 83611-5506
Phone Number 2089394599
Gender M
Graduation Year 2016
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 1153609813
Number of Group Practice Members 51
Accepts Medicare Assignment Y

Other Locations

Address Phone Organization
7733 W Emerald St, Boise, ID 83704-9020 2089394599 MOUNTAIN WEST DERM - BLACKHART PLLC
271 Duffers Ln, Cascade, ID 83611-5506 2089394599 MOUNTAIN WEST DERM - BLACKHART PLLC

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %
MIPS_EC_224_overall Melanoma: Overutilization of Imaging Studies in Melanoma 100%
MIPS_EC_402_overall Tobacco Use and Help with Quitting Among Adolescents 90%
MIPS_EC_431_overall Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 97%

Organization Information

Organization Legal Name MOUNTAIN WEST DERM - BLACKHART PLLC
Physicians 51

Physicians with the same organization

Name Specialty Organization Address
Alexandria Noel Staub Physician Assistant Mountain West Derm - Blackhart Pllc 2747 Ne Conners Ave, Bend, OR 97701-8738
Irene Helen Mannering Dermatology Mountain West Derm - Blackhart Pllc 640 W Moana Ln, Reno, NV 89509-4903
Michael John Housley Physician Assistant Mountain West Derm - Blackhart Pllc 271 Duffers Ln, Cascade, ID 83611-5506
Dan E Rowe Dermatology Mountain West Derm - Blackhart Pllc 3950 Gs Richards Blvd, Carson City, NV 89703-8457
Doug Starley Physician Assistant Mountain West Derm - Blackhart Pllc 4814 Sparks Blvd, Sparks, NV 89436-8219
James H Stewart Dermatology Mountain West Derm - Blackhart Pllc 7733 W Emerald St, Boise, ID 83704-9020
Anthony E Albregts Dermatology Mountain West Derm - Blackhart Pllc 640 W Moana Ln, Reno, NV 89509-4903
Stephanie A Mcleish Dermatology Mountain West Derm - Blackhart Pllc 3841 Piper St, Suite T4 020, Anchorage, AK 99508-4673
Kimberly A Kolar Dermatology Mountain West Derm - Blackhart Pllc 640 W Moana Ln, Reno, NV 89509-4903
Amy Richelle Schoening Physician Assistant Mountain West Derm - Blackhart Pllc 640 W Moana Ln, Reno, NV 89509-4903

Office Location

Street Address 271 DUFFERS LN
City CASCADE
State ID
Zip 83611-5506

Physicians in the same location

Name Specialty Organization Address
Michael John Housley Physician Assistant Mountain West Derm - Blackhart Pllc 271 Duffers Ln, Cascade, ID 83611-5506
Chelsea Faust Physician Assistant Mountain West Derm - Blackhart Pllc 271 Duffers Ln, Cascade, ID 83611-5506

Physicians in the same zip code

Name Specialty Organization Address
Jennifer S Anderson Cardiovascular Disease (cardiology) Saint Alphonsus Regional Medical Center Inc 402 Lake Cascade Pkwy, Cascade, ID 83611-7702
Marc T Nagel Physician Assistant Cascade Medical Center Hospital District 402 Lake Cascade Pkwy, Cascade, ID 83611-7702
James W Dardis Family Medicine Cascade Medical Center Hospital District 402 Lake Cascade Pkwy, Cascade, ID 83611-7702
Ronald K Ellsworth Family Medicine Cascade Medical Center Hospital District 402 Lake Cascade Pkwy, Cascade, ID 83611-7702
Chantell Williams Nurse Practitioner Cascade Medical Center Hospital District 402 Lake Cascade Pkwy, Cascade, ID 83611-7702
Jamie Coffey Kelly Clinical Social Worker Cascade Medical Center Hospital District 402 Lake Cascade Pkwy, Cascade, ID 83611-7702

Competitor

Search similar physicians

City CASCADE
Zip Code 83611
Specialty PHYSICIAN ASSISTANT
City + Specialty CASCADE + PHYSICIAN ASSISTANT

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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