Individual provider Active NPI

Tyler Charles Ensley, D.O.

  • Emergency Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1124223581
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS15967 Issued in FL
Practice address
Cape Coral Hospital
636 Del Prado Blvd
Cape Coral, FL 33990
Phone
(239) 424-3513
Fax
(239) 424-4039
NPI assigned
Jun 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS15967 FL Primary

Addresses

Primary practice location

Cape Coral Hospital
636 Del Prado Blvd
Cape Coral, FL 33990

Mailing address

PO Box 151368
Cape Coral Emergency Physicians, LLC
Cape Coral, FL 33915
Phone (239) 424-3513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170125001583 CA Practitioner - Emergency Medicine 0345522421 Reassigns benefits to 1 organization
I20190829000519 FL Practitioner - Emergency Medicine 0345522421 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City College of Medicine and Surgery, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

636 Del Prado Blvd S
Cape Coral, FL 33990-2668
Phone (239) 424-3513

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10496CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Coral Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Lee Health System Inc CurrentSince Jan 31, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Aug 14, 2019 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Lee Health System Inc CurrentSince Jan 31, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Aug 14, 2019 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

Networks

  • Freedom Health HMO Network

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 2

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": "1182038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1124223581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151368",
            "address_2": "CAPE CORAL EMERGENCY PHYSICIANS, LLC",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33915",
            "telephone_number": "239-424-3513",
            "fax_number": "239-424-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAPE CORAL HOSPITAL",
            "address_2": "636 DEL PRADO BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "239-424-3513",
            "fax_number": "239-424-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSLEY",
        "first_name": "TYLER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-17",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS15967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.