Mark Tyrrell, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA170880 Issued in OR

Practice address

202 NW 13TH Ave
Portland, OR 97209-2953

Phone

(503) 684-8252

NPI assigned

Dec 31, 2014

Last updated

Dec 31, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in WA, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: mark.tyrrell.1@30646.direct.athenahealth.com

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.

• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group
• Zoomcare PC

  dba ZoomCare

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1124416946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DR",
            "address_2": "STE 200",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245860",
            "telephone_number": "503-684-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 NW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092953",
            "telephone_number": "503-684-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRRELL",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA170880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Tyler, NNP
• Michelle Tyler, CASE MANAGER
• Rodney Allen Tyler
• Cheri Tynan I
• Elizabeth Nicole Tyning, LCSW
• Rose Marie Tyson, RN, ANP
• Frank Tzeo, MS
• Carolyn Tziu
• Rodrigo Tzovenos Starosta, MD, PHD
• U.S. Medgroup, P.a.

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.