Tyler Lee Sanders, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2021010812 Issued in MO

Practice address

620 E Monroe St
Mexico, MO 65265-2919

Phone

(660) 728-0061

NPI assigned

May 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

80.23 of 100Reported as group

Quality

58.17

Promoting interoperability

100

Improvement activities

40

Cost

75.92

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• The Curators of the University of Missouri

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1235126921
  Medicare reassignment
• Curators of the University of Missouri

  • Durable Medical Equipment & Medical Supplies
  • Columbia, MO
  • NPI 1356963201
  NPD
• Noble Health Audrain Inc

  • Orthopaedic Surgery Physician
  • Sedalia, MO
  • NPI 1043944499
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1033784111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E MONROE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652919",
            "telephone_number": "660-728-0061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3916 S Providence Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652037152",
            "country_code": "US",
            "telephone_number": "573-882-1662",
            "fax_number": "573-882-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3626 S Clark St",
            "address_purpose": "LOCATION",
            "city": "Mexico",
            "state": "MO",
            "postal_code": "652654104",
            "country_code": "US",
            "telephone_number": "573-581-1812",
            "fax_number": "573-581-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "TYLER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021010812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220099242",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3916 S Providence Rd Ste 101",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652037152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jerri Dawn Robertson, D.O.
• Katherine D Robinson, MS
• Sarah M Roling, DC
• McKenzi Kea Ross, FNP
• Justine Nikole Rush
• Virginia B Schenck, LPC
• Lisa K. Schriewer-Clervi, PSYCHOLOGIST
• Dawn Schuette
• James Allen Scott, D.C.
• Shellie Lynn Shaw, RD, LD, CLT

• Physician Assistant in Mexico, MO
• Providers in Mexico, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.