Individual provider Active NPI

John Tyrrell, DO

  • Emergency Medicine Physician
  • Mountain Lakes, NJ
National Provider Identifier
1164441978
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB04141800 Issued in NJ
Practice address
333 US Highway 46 Ste 106
Mountain Lakes, NJ 07046-1741
Phone
(973) 939-6220
Fax
(973) 263-0281
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB04141800 NJ Primary

Addresses

Primary practice location

333 US Highway 46 Ste 106
Mountain Lakes, NJ 07046-1741

Mailing address

465 South St Ste 103
Morristown, NJ 07960-6442
Phone (973) 695-4726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000006 NJ Practitioner - Emergency MedicinePractitioner - General Practice 1557333499 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Hackettstown Emergency Medical Associates LLC Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Atlantic Advanced Urgent Care Emergency Medicine CurrentSince Mar 17, 2024 Accepting new patients
Union Emergency Medical Associates LLC Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Atlantic Urgent Care, LLC CurrentSince Mar 17, 2024 Accepting new patients
William R. Collini, M.D., P.a. PastSince Mar 17, 2024 Accepting new patients
Practice Associates Medical Group Emergency Medicine Past Accepting new patients
Newton Emergency Medical Associates LLC Emergency Medicine PastSince Aug 17, 2025 Accepting new patients
Emergency Medical Associates of New Jersey PA Emergency Medicine Past Accepting new patients
Emergency Medical Associates of New Jersey PA Emergency Medicine PastSince May 10, 2020 Accepting new patients

Locations

140 Central Ave
Clark, NJ 07066
Phone (732) 499-0606

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

333 US Highway 46
Ste 106
Mountain Lks, NJ 07046
Phone (973) 829-7965

181 High St
Newton, NJ 07860
Phone (973) 383-9898

376 Route 15
Ste 101
Sparta, NJ 07871
Phone (973) 383-9898

1000 Galloping Hill Rd
Union, NJ 07083
Phone (908) 522-6280

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1164441978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SOUTH ST STE 103",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606442",
            "telephone_number": "973-695-4726",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 US HIGHWAY 46 STE 106",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461741",
            "telephone_number": "973-939-6220",
            "fax_number": "973-263-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRRELL",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB04141800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Lakes, NJ

Sources for this page

Verify at the official NPI Registry.