NPIMap

Individual provider Active NPI

Tyler James Popil, PA-C

  • Physician Assistant
  • Willoughby, OH
National Provider Identifier
1235638263
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
36100 Euclid Ave Ste 240
Willoughby, OH 44094-4427
Phone
(440) 953-6294
Fax
(440) 918-4687
NPI assigned
Feb 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

36100 Euclid Ave Ste 240
Willoughby, OH 44094-4427

Mailing address

36100 Euclid Ave Ste 240
Willoughby, OH 44094-4427
Phone (440) 953-6294

Other identifiers 3

IdentifierTypeStateIssuer
50.005472RXOtherOHOHIO ELICENSURE OHIO PROFESSIONAL LICENSURE
0265766MedicaidOH
0265766OtherOHNCCPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180308001756 OH Practitioner - Physician Assistant 4082975073 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

36100 Euclid Ave
Willoughby, OH 44094-4427

36100 Euclid Ave
Suite 450
Willoughby, OH 44094-4488
Phone (440) 946-9555

36500 Euclid Ave
Willoughby, OH 44094-4455
Phone (440) 516-0530

Hospital & facility affiliations

  • Elara Caring Home health agency, Mentor, OH, CCN 367173
  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Lake Health Hospital, Concord, OH, CCN 360098
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince Oct 8, 2023 Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2019 Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2019 Accepting new patients
Lake Hospital System Inc CurrentSince Oct 8, 2023 Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
Lake Hospital System, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

15976 E High St
Ste 100
Middlefield, OH 44062
Phone (440) 632-0770

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

36100 Euclid Ave
Ste 240
Willoughby, OH 44094
Phone (216) 953-6294

Interoperability endpoints

  • Direct secure messaging: tpopil21145@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1235638263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36100 EUCLID AVE STE 240",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944427",
            "telephone_number": "440-953-6294",
            "fax_number": "440-918-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36100 EUCLID AVE STE 240",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944427",
            "telephone_number": "440-953-6294",
            "fax_number": "440-918-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPIL",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO ELICENSURE OHIO PROFESSIONAL LICENSURE",
            "identifier": "50.005472RX",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265766",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "0265766",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.