NPIMap

Individual provider Active NPI

Tyler Fong, MD

  • Anesthesiology Physician
  • Orlando, FL
National Provider Identifier
1023541646
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME151110 Issued in FL
Practice address
62 Columbia St
Orlando, FL 32806-1115
Phone
(321) 214-4903
Fax
(321) 841-2196
NPI assigned
Apr 10, 2017
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X ME151110 FL Primary

Addresses

Primary practice location

62 Columbia St
Orlando, FL 32806-1115

Mailing address

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 214-4903

Other identifiers 1

IdentifierTypeStateIssuer
111518200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210826000725 FL Practitioner - Anesthesiology 0840695029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

3450 Hull Rd
Gainesville, FL 32607-4144

3450 SW Hull Rd
Uf Health Pediatric Urology Osmi
Gainesville, FL 32607-4144
Phone (352) 265-8240

3480 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 338-7100

4101 NW 89TH Blvd
Gainesville, FL 32606-3813

6201 W Newberry Rd
Uf Health the Oaks
Gainesville, FL 32605-4305
Phone (352) 265-9465

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151110FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 21, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 21, 2023 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tfong540488@direct.shands.ufl.edu

Organizations & group practices 4

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

Hospital & facility affiliations 8

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1023541646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "321-214-4903",
            "fax_number": "321-841-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "321-214-4903",
            "fax_number": "321-841-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME151110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111518200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.