Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Jordan Pond, PA-C

Individual provider Physician Assistant · NPI 1356844500

Tyler Jordan Pond, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2017, 9 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

150 N Woodruff Ave
Idaho Falls, ID 83401-4335
Phone: (208) 557-3255
Fax: (208) 471-5069
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1590 (ID)

Record details

NPI number1356844500
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 14, 2018
Last updated in NPPESDecember 23, 2025
Certification dateDecember 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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