Individual provider Active NPI

Aaron Tyree, PA

  • Physician Assistant
  • Washington, MO
National Provider Identifier
1093965840
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2009030559 Issued in MO
Practice address
901 E 5TH St
Washington, MO 63090-3127
Phone
(636) 239-8011
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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 2009030559 MO Primary

Addresses

Primary practice location

901 E 5TH St
Washington, MO 63090-3127

Mailing address

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8011

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091019000109 MO Practitioner - Physician Assistant 5890863567 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

Hospital & facility affiliations

  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009030559MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Feb 20, 2023 Accepting new patients
Cep America LLC CurrentSince Feb 1, 2015 Accepting new patients
Cep America LLC CurrentSince Feb 1, 2015 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1093965840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "AARON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009030559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.