Individual provider Active NPI

Tyler J Glenn, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Scottsdale, AZ
National Provider Identifier
1013991173
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
33292 Issued in AZ
Practice address
7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone
(480) 994-9838
Fax
(480) 994-5811
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 33292 AZ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 33292 AZ Primary
Internal Medicine Physician 207R00000X 33292 AZ

Addresses

Primary practice location

7400 E Osborn Rd
Scottsdale, AZ 85251-6432

Mailing address

7301 E 2ND St Ste 315
Scottsdale, AZ 85251-5627
Phone (480) 994-9838

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
I20090828000188 AZ Practitioner - Critical Care (Intensivists) 9931254844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
University of Arizona College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scottsdale Pulmonary and Critical Care LLCGroup PAC ID 3375876758, 13 clinicians

Practice addresses (Care Compare)

7301 E 2ND St
Suite 315
Scottsdale, AZ 85251-5627
Phone (480) 994-9838

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33292AZMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Pulmonary and Critical Care, LLC Critical Care Medicine CurrentSince Mar 25, 2024 Accepting new patients
Honorhealth Past Accepting new patients

Locations

7301 E 2nd St
Ste 315
Scottsdale, AZ 85251
Phone (480) 947-7711

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1013991173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 E 2ND ST STE 315",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515627",
            "telephone_number": "480-994-9838",
            "fax_number": "480-994-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "480-994-9838",
            "fax_number": "480-994-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "TYLER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "33292",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "33292",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.