Individual provider Active NPI

Tyler Robert Shiflett, DO

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1013409580
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R3062 Issued in AZ
Practice address
2200 E River Rd Ste 112
Tucson, AZ 85718-6577
Phone
(520) 888-3553
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R3062 AZ Primary

Addresses

Primary practice location

2200 E River Rd Ste 112
Tucson, AZ 85718-6577

Mailing address

2200 E River Rd Ste 112
Tucson, AZ 85718-6577
Phone (520) 888-3553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230407000129 AZ Practitioner - Psychiatry 4486905312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 E River Rd
Suite 112
Tucson, AZ 85718-6577
Phone (520) 888-3553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R3062AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TKS Psychiatry CurrentSince Mar 21, 2023 Accepting new patients

Locations

2200 E River Rd
Ste 112
Tucson, AZ 85718
Phone (520) 888-3553

Organizations & group practices 1

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1013409580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E RIVER RD STE 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186577",
            "telephone_number": "520-888-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E RIVER RD STE 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186577",
            "telephone_number": "520-888-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFLETT",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "R3062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.