Tyler R. Van Wagenen, PA
NPI 1700656352ActiveIndividual· Physician Assistant· Ontario, OR
Physician Assistant (PA) with Valley Family Health Care Inc, practicing in Ontario, Oregon. Their prescriptions cost Medicare Part D more than their services did: $71,083 for 584 claims, against $307.95 paid for services in 2024. Lists Saint Alphonsus Medical Center Ontario and 1 other hospital as hospital affiliations.
Overview
| NPI | 1700656352 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | Yes |
| NPI issued | Jan 4, 2024 |
| Last updated in NPPES | Jan 14, 2026 |
| Certified by provider | Jan 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA219187 | OR |
| Physician Assistant | 363A00000X | PA2766 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (ID); Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 20 |
|---|---|
| Services billed | 41 across 6 procedure codes |
| Paid by Medicare | $307.95 |
Part D prescriptions in 2024
| Prescriptions (claims) | 584 · 1,175 30-day fills |
|---|---|
| Patients | 90 |
| Total drug cost | $71,083 |
| Generic share | 84% of claims |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Valley Family Health Care IncPayette, ID · 47 clinicians
Hospital affiliations
- Saint Alphonsus Medical Center OntarioOntario, OR
- St Luke's Regional Medical CenterBoise, ID
Other facilities
- Canyon Home Care & HospiceHome health agency · Fruitland, ID
- Enhabit Home Health of Western IdahoHome health agency · Fruitland, ID
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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