Individual provider Active NPI

Tyler Herman, PT, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1225504814
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043154-1 Issued in NY
Practice address
1045 James St
Syracuse, NY 13203-2730
Phone
(315) 425-1004
Fax
(315) 422-4855
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 043154-1 NY Primary

Addresses

Primary practice location

1045 James St
Syracuse, NY 13203-2730

Mailing address

1045 James St
Syracuse, NY 13203-2730
Phone (315) 425-1004

Other identifiers 1

IdentifierTypeStateIssuer
5087OtherLIBERTY RESOURCES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190227000584 NY Practitioner - Physical Therapist in Private Practice 1254670805
I20251106000393 CT Practitioner - Physical Therapist in Private Practice 1254670805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carlson Therapy Network PCGroup PAC ID 8527968445, 18 clinicians

Practice addresses (Care Compare)

116 Danbury Rd
New Milford, CT 06776-3441
Phone (860) 354-7605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043154NYMDDentist
043154-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlson Therapy Network, PC Physical Therapist CurrentSince Sep 26, 2025 Accepting new patients

Locations

816 Broad St
Meriden, CT 06450
Phone (203) 238-1334

6 Shaws Cv
Ste 101
New London, CT 06320
Phone (860) 444-9022

116 Danbury Rd
New Milford, CT 06776
Phone (203) 794-6331

116 Danbury Rd
Ste 5
New Milford, CT 06776
Phone (860) 354-7605

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.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1225504814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-425-1004",
            "fax_number": "315-422-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-425-1004",
            "fax_number": "315-422-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "TYLER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043154-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIBERTY RESOURCES",
            "identifier": "5087",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.