Individual provider Active NPI

Julie Anne Tyler, MIDWIFE

  • Midwife
  • Mount Vernon, NY
National Provider Identifier
1013242817
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
001338 Issued in NY
Practice address
107 W 4TH St
Mount Vernon, NY 10550-4002
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F001338-1 NY
Midwife 176B00000X 001338 NY Primary

Addresses

Primary practice location

107 W 4TH St
Mount Vernon, NY 10550-4002

Mailing address

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone (914) 699-7200

Other identifiers 1

IdentifierTypeStateIssuer
03161626MedicaidNY

Other names 1

  • Ms. Julie Anne O'Connor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100304000057 NY Practitioner - Certified Nurse Midwife (CNM) 8123163052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F001338-1NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince May 20, 2017 Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince May 20, 2017 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1013242817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MIDWIFE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001338-1",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "001338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03161626",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "O'CONNOR",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "CM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.