Patricia A. Tyra, RN/PC,PMHCNS-BC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

RN83437 Issued in MA

Practice address

111 Edgartown Road
Oak Bluffs, MA 02557

Phone

(508) 693-7900

Fax

(508) 696-0401

NPI assigned

Jul 13, 2011

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Martha'S Vineyard Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Bluffs, MA
  • NPI 1659387074
  NPD (past)

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1063700888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025680369",
            "telephone_number": "508-693-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EDGARTOWN ROAD",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "02557",
            "telephone_number": "508-693-7900",
            "fax_number": "508-696-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRA",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "credential": "RN/PC,PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN83437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe M Tagan
• Sandra A Talanian, BSN, MPH
• Robert Tankard
• Town of Oak Bluffs
• Sara Kathleen Townes, MSW
• Lisa Marie Vieira-Salvatore, MD
• Vineyard Dermatology Inc
• Vineyard Ekg Billing Associates
• Vineyard Nursing Association, Inc.
• Alamjit Virk, MD

• Psychiatric/Mental Health Clinical Nurse Specialist in Oak Bluffs, MA
• Providers in Oak Bluffs, MA by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.