Tyler Lyall Hanson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9119365 Issued in FL

Practice address

929 North US Hwy 441/27
Suite 601
Lady Lake, FL 32159

Phone

(352) 633-0473

Fax

(866) 208-9972

NPI assigned

Oct 18, 2024

Last updated

Mar 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Juan C Yordan MD PAGroup PAC ID 8527363431, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pinnacle Home Care of the Villages Inc Home health agency, The Villages, FL, CCN 109702

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DAEBBD/Endpoint/DAEBBD

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.

• Juan C Yordan MD PA

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1184094690
  Medicare reassignment Care Compare group
• Mental Health of Central Florida, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lady Lake, FL
  • NPI 1497221865
  NPD

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

• Pinnacle Home Care of the Villages LLC

  • Home Health Agency
  • The Villages, FL
  • NPI 1982933321
  Care Compare affiliation

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1043031453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 N US HWY 441 STE 601",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593003",
            "telephone_number": "352-633-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 NORTH US HWY 441/27",
            "address_2": "SUITE 601",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-633-0473",
            "fax_number": "866-208-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "TYLER",
        "middle_name": "LYALL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Mark Hamm, PT
• William M Hammesfahr, MD
• David J Hancock, DPM
• Christopher Joel Handy, LMT
• Sangeeta Hans, M.D.
• Erica Harden, A.R.N.P.
• Emily Harmon, RPH
• Krestana Kay Hart, ARNP
• Kathleen Harvey
• Meagan Kristi Havenstein

• Medical Physician Assistant in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.