Individual provider Active NPI

Tyler Marie Tatro, PT, DPT

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1205660974
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16947-24 Issued in WI
Practice address
1727 Shawano Ave
Green Bay, WI 54303-3268
Phone
(920) 496-4700
NPI assigned
Aug 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP033644T TX
Physical Therapist 225100000X 16947-24 WI Primary

Addresses

Primary practice location

1727 Shawano Ave
Green Bay, WI 54303-3268

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ttatro503623@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250203002347 WA Practitioner - Physical Therapist in Private Practice 0749710937 Reassigns benefits to 1 organization
I20250915003405 CA Practitioner - Physical Therapist in Private Practice 0749710937 Reassigns benefits to 1 organization
I20251224001103 WI Practitioner - Physical Therapist in Private Practice 0749710937 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shasta Lake Physical TherapyGroup PAC ID 1557304896, 6 clinicians

Practice addresses (Care Compare)

1727 Shawano Ave
Green Bay, WI 54303-3268
Phone (920) 496-4700

5061 Shasta Dam Blvd
Shasta Lake, CA 96019-9405
Phone (530) 275-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP033644TTXMDPhysical Therapist
16947-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Physical Therapist CurrentSince Dec 1, 2025 Accepting new patients
Multicare Health System CurrentSince Jan 1, 2025 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Dec 1, 2025 Accepting new patients
Multicare Health System Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Dec 1, 2025 Accepting new patients
Shasta Lake Physical Therapy Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Dec 1, 2025 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

5061 Shasta Dam Blvd
Shasta Lake, CA 96019
Phone (530) 275-0777

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2405 N Pearl St
Ste 18
Tacoma, WA 98406
Phone (253) 503-1560

1727 Shawano Ave
Green Bay, WI 54303
Phone (920) 431-1810

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 10

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": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1205660974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033268",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATRO",
        "first_name": "TYLER",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "CP033644T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16947-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttatro503623@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1727 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.