Individual provider Active NPI

Tyler Joseph Burg, PA-C

  • Surgical Physician Assistant
  • Charleston, SC
National Provider Identifier
1144749250
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4958 Issued in SC
Practice address
2145 Henry Tecklenburg Dr Ste 220
Charleston, SC 29414-5894
Phone
(843) 723-8823
NPI assigned
Sep 11, 2017
Last updated
Feb 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4958 SC Primary

Addresses

Primary practice location

2145 Henry Tecklenburg Dr Ste 220
Charleston, SC 29414-5894

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tyler.burg@aah.org ADVOCATE HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, SC2 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

Enrollment IDStateProvider typePAC IDDetails
I20210108001080 AZ Practitioner - Physician Assistant 2860759727 Reassigns benefits to 3 organizations
I20231114000374 SC Practitioner - Physician Assistant 2860759727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

13677 W McDowell Rd
Suite 201
Goodyear, AZ 85395-2635
Phone (623) 536-4200

18701 N 67TH Ave
Glendale, AZ 85308-7100
Phone (623) 561-1000

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 723-6426

2145 Henry Tecklenburg Dr
Charleston, SC 29414-5894

300 Callen Blvd
Summerville, SC 29486-2809

3500 N Hwy 17
Mt Pleasant, SC 29466-9123
Phone (843) 723-6426

5130 W Baseline Rd
Suite 102
Laveen, AZ 85339-2984
Phone (602) 237-0039

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7872AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Jan 18, 2021 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 2, 2024 Accepting new patients
Mayo Clinic Arizona CurrentSince Jan 18, 2021 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 2, 2024 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Aug 23, 2021 Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

6036 N 19th Ave
Ste 505
Phoenix, AZ 85015
Phone (602) 249-0839

13400 E Shea Blvd
Scottsdale, AZ 85259

2145 Henry Tecklenburg Dr
Ste 220
Charleston, SC 29414
Phone (843) 958-2555

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: tburg1350363@ehrdirect.mayoclinicmsg.org

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1144749250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 HENRY TECKLENBURG DR STE 220",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145894",
            "telephone_number": "843-723-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURG",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.burg@aah.org",
            "affiliation": "Y",
            "affiliationName": "ADVOCATE HEALTH CARE",
            "address_1": "3815 Highland Ave",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.