Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1568013779 Deactivated / Inactive NPI Male Practitioner

Tyler Vanderostyne

Registered Nurse • Peoria, IL

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Tyler Vanderostyne has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 28, 2019
NPI Deactivation Date July 26, 2021
Total Practice Duration ~2 Years of Practice (2019 – 2021)

Professional Overview & Biography Verified Profile Summary

Tyler Vanderostyne was a registered Registered Nurse practicing in Peoria, IL. Throughout an active medical career spanning 2 years, Tyler Vanderostyne provided care at the practice location at 815 MAIN ST until profile deactivation on 2021-07-26.

Historical Medicare Part B clinical services included established patient outpatient office visit, therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

815 Main St

Peoria, IL 616021076

Telephone 3096724977

Specialty Benchmarks & Practice Insights

Comparative analytics for Registered Nurse in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.0 Yrs
State Avg: 8.4 Yrs
Regional Practice Density
29 Specialists

Practicing in Peoria, IL (2714 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
47.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
67 32 $144.00 $75.87

Medical Specialties & State Licenses

Registered Nurse Primary Specialty

NUCC Taxonomy Code: 163W00000X

State License IL 041.462539

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Iram Yunus

Family Medicine

NPI 1013323138
Dr. Thomas Chow , DO

Student in an Organized Health Care Education/Training Program

NPI 1043011844

Doctor of Osteopathic Medicine (D.O.)

Dr. Kyle Cotner , MD

Student in an Organized Health Care Education/Training Program

NPI 1053105734

Doctor of Medicine (M.D.)

Demi Castellanos

Student in an Organized Health Care Education/Training Program

NPI 1063206001
Dr. Paige Bonner , DO

Student in an Organized Health Care Education/Training Program

NPI 1093656654

Doctor of Osteopathic Medicine (D.O.)

Nupoor Tillu

Anesthesiology

NPI 1104233006

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated July 26, 2021

Record deactivated on July 26, 2021

NPI Profile Active September 28, 2019

NPI status registered as active in NPPES database

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Updated Practice Location September 28, 2019

Registered at 815 MAIN ST, PEORIA, IL 616021076 (Tel: 3096724977)

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Updated Business Mailing Address September 28, 2019

Registered at 1700 W CONEFLOWER DR, PEORIA, IL 616151460

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Provider Name / Credentials Updated September 28, 2019

Recorded as TYLER VANDEROSTYNE

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2019

Registered Nurse (License #041.462539 in IL)

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Initial NPI Registration & Enumeration September 28, 2019

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: 1568013779
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 28, 2019
Last Update: September 28, 2019
Deactivation Date: July 26, 2021

Mailing Address

1700 W Coneflower Dr

Peoria, IL 616151460

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.