Individual provider Active NPI

Howard V. Tyree, PA-C

  • Physician Assistant
  • Traverse City, MI
National Provider Identifier
1053545657
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003680 Issued in MI
Practice address
4075 Copper Ridge Dr
Traverse City, MI 49684-7059
Phone
(231) 946-8970
Fax
(231) 932-4118
NPI assigned
May 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003680 MI Primary
Emergency Medicine Physician 207P00000X 5601003680 MI

Addresses

Primary practice location

4075 Copper Ridge Dr
Traverse City, MI 49684-7059

Mailing address

4075 Copper Ridge Dr
Traverse City, MI 49684-7059
Phone (231) 946-8970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20031113000757 MI Practitioner - Physician Assistant 3971417049 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003680MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Group CurrentSince Nov 5, 2014 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Sep 18, 2014 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Jan 13, 2015 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2015 Accepting new patients
Mymichigan Medical Center Gladwin Physician Assistant CurrentSince Nov 5, 2014 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2015 Accepting new patients
Michigan Emergency Physicians LLP Emergency Medicine CurrentSince May 21, 2009 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Nov 5, 2014 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Jan 13, 2015 Accepting new patients

Locations

75 Remit Dr
Ste 6895
Chicago, IL 60675

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

9249 W Lake City Rd
Houghton Lake, MI 48629
Phone (989) 422-2183

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

5912 Eastman Ave
Midland, MI 48640
Phone (517) 832-6403

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

Interoperability endpoints

  • Direct secure messaging: htyree7025@mymichiganhealth.midirect.net

Organizations & group practices 12

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": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1053545657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 COPPER RIDGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847059",
            "telephone_number": "231-946-8970",
            "fax_number": "231-932-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 COPPER RIDGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847059",
            "telephone_number": "231-946-8970",
            "fax_number": "231-932-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "HOWARD",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003680",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5601003680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.