Tyler Curtis Page, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

001879 Issued in CT

Practice address

12 Coogan Blvd Ste 204
Mystic, CT 06355-1938

Phone

(860) 245-4620

Fax

(860) 245-5752

NPI assigned

Mar 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mystic Spine & Sport LLC

  • Chiropractor
  • Mystic, CT
  • NPI 1952692592
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1154620037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COOGAN BLVD STE 204",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551938",
            "telephone_number": "860-245-4620",
            "fax_number": "860-245-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 COOGAN BLVD STE 204",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551938",
            "telephone_number": "860-245-4620",
            "fax_number": "860-245-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "TYLER",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001879",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CT",
            "license": "001879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0100045708",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Old Mystic Fire District
• Sari Ann Oliver
• Optimystic LLC
• Brian Kristofer Owczarski
• Lisa Pacifico, P.T.
• Mary Ellen Pagnozzi, A.P.R.N.
• Adrienne Lynne Marold Parad, M.D.
• Prior Lewis Parker, MD
• Gaetano Michael Patalano, MHC
• Melissa Paul, DPT

• Rehabilitation Chiropractor in Mystic, CT
• Providers in Mystic, CT by specialty
• Rehabilitation Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.