Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730673419 Individual Practitioner Male Practitioner

Dr. Tysen L Weber , MD

Pediatrics • Lewiston, ID

Professional Overview & Biography Verified Profile Summary

Dr. Tysen Weber, MD is a registered healthcare professional specializing in Pediatrics in Lewiston, ID. Practice services are available at 2315 8TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2315 8th St

Lewiston, ID 835017301

Telephone 2087461383
Fax 2087466348
Associated Practice Facility / Clinic
🏢 Valley Medical Center, Pllc Facility NPI 1942227699

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Lewiston, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 43.0 Yrs
State Avg: 19.3 Yrs
Regional Practice Density
8 Specialists

Practicing in Lewiston, ID (228 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-15
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License ID M-15702

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License WA MD61156866

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1730673419 (WA)
Medicaid State Provider ID
1730673419 (ID)

Secondary Practice Locations

2216 Vineyard Ave

Lewiston, ID 835016352

Phone: 2082890425

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003861626

Doctor of Medicine (M.D.)

NPI 1013090828

Doctor of Medicine (M.D.)

NPI 1013090836

Doctor of Medicine (M.D.)

Robert Mahal , NP

Nurse Practitioner

NPI 1063745206

Nurse Practitioner

NPI 1144262098

Doctor of Medicine (M.D.)

Dr. Sherry Stoutin , MD

General Practice

NPI 1184707903

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Business Mailing Address April 15, 2025

Registered at 2216 VINEYARD AVE, LEWISTON, ID 835016352 (Tel: 2082890425)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2025

Pediatrics (License #MD61156866 in WA)

📍
Updated Practice Location July 21, 2021

Registered at 2315 8TH ST, LEWISTON, ID 835017301 (Tel: 2087461383)

📍
Updated Business Mailing Address July 21, 2021

Registered at 2315 8TH ST, LEWISTON, ID 835017301 (Tel: 2087461383)

👤
Provider Name / Credentials Updated July 21, 2021

Recorded as TYSEN WEBER, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2021

Pediatrics (License #M-15702 in ID)

NPI Profile Active June 18, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location June 18, 2018

Registered at 3601 4TH ST STOP 9406, LUBBOCK, TX 794309406 (Tel: 8067436630)

📍
Updated Business Mailing Address June 18, 2018

Registered at 3601 4TH ST STOP 9406, LUBBOCK, TX 794309406

👤
Provider Name / Credentials Updated June 18, 2018

Recorded as TYSEN WEBER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 18, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 18, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730673419
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 18, 2018
Last Update: April 15, 2025
Sole Proprietor: No

Mailing Address

2216 Vineyard Ave

Lewiston, ID 835016352

Phone: 2082890425

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.