Tyler Jordan Israel

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC200 Issued in KY

Practice address

1200 Breckenridge St
Owensboro, KY 42303-1089

Phone

(270) 683-8672

Fax

(270) 685-8233

NPI assigned

Mar 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, KY, IN3 enrollments

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 3

Specialty

Physician Assistant

Education

Florida International Univ, College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matthew 25 AIDS Services IncGroup PAC ID 3375513641, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEHBBA/Endpoint/BEHBBA

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.

• Matthew 25 AIDS Services Inc

  • Clinic/Center
  • Henderson, KY
  • NPI 1457355125

  IN, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Owensboro Medical Practice, PLLC

  • Cardiovascular Disease Physician
  • Owensboro, KY
  • NPI 1851315105
  Medicare reassignment
• Surgical Group of Miami LLC

  • Vascular Surgery Physician
  • Miami, FL
  • NPI 1861495293
  Medicare reassignment
• Radiology Associates of South Florida LLC

  • Diagnostic Radiology Physician
  • Longview, TX
  • NPI 1699759183
  NPD (past)

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1235697301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13120 SW 92ND AVE PH 19",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768707",
            "telephone_number": "270-313-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031089",
            "telephone_number": "270-683-8672",
            "fax_number": "270-685-8233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8950 N Kendall Dr Ste 504",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762132",
            "country_code": "US",
            "telephone_number": "270-313-7347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "TYLER",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Impetus Health and Wellness
• Integrated Therapy Solutions, PLLC
• Integrative Behavioral Health and Alternative Healing Arts, LLC
• Intuitive Wellness Center
• Catherine Deanna Isbill, PTA
• Ivory Howell Counseling, LLC
• J Anthony Holder,MD,PLLC
• J Mills Enterprises LLC
• J Ross PSC
• J&J Housing

• Physician Assistant in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.