Tyler O Benelli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

114 East Ave
Wellsboro, PA 16901-1737

Phone

(570) 723-0620

Fax

(570) 724-0675

NPI assigned

Apr 11, 2011

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Penn Comprehensive Health ServicesGroup PAC ID 0446245880, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyler.benelli@upmcdirect.com

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.

• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Wellsboro, PA
  • NPI 1912093576
  Medicare reassignment Care Compare group NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Elkland, PA
  • NPI 1003913955
  NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Laporte, PA
  • NPI 1093520587
  NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Mansfield, PA
  • NPI 1376923896
  NPD
• North Penn Comprehensive Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellsboro, PA
  • NPI 1346461381
  NPD (past)

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1144510280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1982",
            "fax_number": "570-662-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 EAST AVE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011737",
            "telephone_number": "570-723-0620",
            "fax_number": "570-724-0675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 W Wellsboro St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "PA",
            "postal_code": "169331411",
            "country_code": "US",
            "telephone_number": "570-662-1974",
            "fax_number": "570-662-2390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "416 S Main St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "PA",
            "postal_code": "169331510",
            "country_code": "US",
            "telephone_number": "570-662-2002",
            "fax_number": "570-662-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENELLI",
        "first_name": "TYLER",
        "middle_name": "O",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Charles Bathrick, RN-BSN
• Robbyn Bathrick
• Victor Paul Becker, M.D.
• Edward L Bellinger, M.D.
• Laura Catherine Bellows, DC
• Mitchell H. Bialor, D.D.S.
• James Biery, PA-C
• Micah P Bingham, OTR
• Elizabeth A Blanton, LCSW
• Stephen T Bortz, PHARMD

• Clinical Social Worker in Wellsboro, PA
• Providers in Wellsboro, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.