Individual provider Active NPI

Tyler Daniel Budziszewski, PA-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1093297608
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060073 Issued in PA
Practice address
145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone
(814) 454-1142
Fax
(814) 454-1255
NPI assigned
Aug 30, 2018
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060073 PA Primary

Addresses

Primary practice location

145 W 23Rd St Ste 101
Erie, PA 16502-2858

Mailing address

145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone (814) 454-1142

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbudziszewski179687@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190108001884 PA Practitioner - Physician Assistant 2365788692 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

145 W 23Rd St
Erie, PA 16502-2858

155 E State St
Albion Family Practice
Albion, PA 16401-1347
Phone (814) 756-4917

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc CurrentSince Nov 18, 2018 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

145 W 23rd St
Ste 101
Erie, PA 16502
Phone (814) 452-2767

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1093297608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-454-1142",
            "fax_number": "814-454-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-454-1142",
            "fax_number": "814-454-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDZISZEWSKI",
        "first_name": "TYLER",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbudziszewski179687@direct.ahn.org",
            "affiliation": "N",
            "address_1": "145 W 23rd St Ste 101",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165022858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.