Active NPI
Tyler William Popp
- Physician Assistant
- Gloversville, NY
National Provider Identifier
1144014788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 99 E State St
Gloversville, NY 12078-1293 - Phone
- (518) 725-8621
- NPI assigned
- Apr 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
99 E State St
Gloversville, NY 12078-1293
Mailing address
39 Firetower Rd
Killingworth, CT 06419-1209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 Corporate Blvd
Lafayette, LA 70508-3844
200 Corporate Blvd
Lafayette, LA 70508-3870
Hospital & facility affiliations
- Nathan Littauer Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034261 | NY | MD | Physical Therapist |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Gloversville, NY
- NPI 1518205491
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gloversville, NY
- NPI 1538296207
-
- Rural Acute Care Hospital
- Gloversville, NY
- NPI 1336145168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1144014788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 FIRETOWER RD",
"city": "KILLINGWORTH",
"state": "CT",
"postal_code": "064191209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 E STATE ST",
"city": "GLOVERSVILLE",
"state": "NY",
"postal_code": "120781293",
"telephone_number": "518-725-8621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPP",
"first_name": "TYLER",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-08",
"last_updated": "2025-04-08",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloversville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.