Tyler Roberts, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

15 Exchange Dr
Lugoff, SC 29078-9198

Phone

(803) 670-8238

NPI assigned

Aug 12, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina ENT Allergy and Sleep Medicine PAGroup PAC ID 0840214748, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tylerroberts@syv.allscriptsdirect.net

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.

• South Carolina ENT Allergy & Sleep Medicine PA

  • Otolaryngology Physician
  • Lugoff, SC
  • NPI 1134153083
  Medicare reassignment Care Compare group
• Diagnostic Pro Imaging

  • Diagnostic Radiology Physician
  • El Paso, TX
  • NPI 1346777190
  NPD (past)

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

• Medical University Hospital Authority

  dba MUSC Health Columbia Medical Center Northeast

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1285200105
  Care Compare affiliation
• Medical University Hospital Authority

  dba MUSC Health Columbia Medical Center Downtown

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1558937474
  Care Compare affiliation
• Medical University Hospital Authority

  • Urgent Care Clinic/Center
  • Columbia, SC
  • NPI 1578402764

  Hospital

  Care Compare affiliation
• Medical University Hospital Authority

  dba MUSC Health Fairfield Emergency and Imaging Center

  • Clinic/Center
  • Winnsboro, SC
  • NPI 1811563737

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1164033353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EXCHANGE DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789198",
            "telephone_number": "803-670-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EXCHANGE DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789198",
            "telephone_number": "803-670-8238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Private",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "40241",
            "country_code": "US",
            "telephone_number": "502-322-7192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4796",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayla R Ramey, APRN
• Katelyn Ramold
• Rachel Bane Raper, ASHA CERTIFIED
• Karissa Rector
• Retireease Senior Services, Inc.
• Laurie C. Robinson, MSP, CCC-SLP
• Erin Rollings, PHARM D
• Ronnetta J. P. Sartor, DMD, LLC (Lugoff Smiles)
• Sandhills Medical Foundation (SAndhills Medical Pharmacy)
• Sandhills Medical Foundation (Sandhills Medical Pharmacy)

• Physician Assistant in Lugoff, SC
• Providers in Lugoff, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.