Individual provider Active NPI

Tyla Hughes

  • Medical Physician Assistant
  • Woodbury, MN
National Provider Identifier
1154909513
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
14018 Issued in MN
Practice address
217 Radio Dr
Woodbury, MN 55125-5805
Phone
(651) 702-0750
Fax
(651) 645-6166
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 14018 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

217 Radio Dr
Woodbury, MN 55125-5805

Mailing address

215 Radio Dr Ste 202
Woodbury, MN 55125-5822
Phone (651) 702-0750

Other practice location 1

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Other practice location 2

11020 161st St W
Lakeville, MN 55044-6507
Phone (651) 702-0750

Other practice location 3

3460 Promenade Ave
Eagan, MN 55123-4404
Phone (651) 702-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220810001006 MN Practitioner - Physician Assistant 2365825288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otolaryngology and Head and Neck Surgery PAGroup PAC ID 1658268651, 38 clinicians

Practice addresses (Care Compare)

11020 161St St W
Lakeville, MN 55044-6507
Phone (651) 702-0750

215 Radio Dr
Suite 202
Woodbury, MN 55125-5805

217 Radio Dr
Woodbury, MN 55125-5805
Phone (651) 702-0750

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology & Head & Neck Surgery, P.a. CurrentSince Jun 27, 2022 Accepting new patients

Locations

3460 Promenade Ave
Eagan, MN 55123

11020 161st St W
Lakeville, MN 55044

3590 Arcade St
Vadnais Heights, MN 55127

217 Radio Dr
Woodbury, MN 55125

215 Radio Dr
Ste 202
Woodbury, MN 55125
Phone (651) 867-9007

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1154909513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 RADIO DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255822",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255805",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3590 Arcade St",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551277135",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11020 161st St W",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550446507",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3460 Promenade Ave",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551234404",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "TYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "14018",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.