Individual provider Active NPI

Robert Anthony Coyle

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1235816158
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11674 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone
(912) 644-5300
NPI assigned
Jul 3, 2023
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 11674 GA Primary

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405-6736

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230731001628 GA Practitioner - Physician Assistant 9830550482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optim Orthopedics LLCGroup PAC ID 9931427002, 101 clinicians
Tattnall Hospital Company LLCGroup PAC ID 6204907124, 47 clinicians

Practice addresses (Care Compare)

17007 Hwy 67
Statesboro, GA 30458-2426
Phone (912) 681-2500

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1000

257 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-8990

3231 Glynn Ave
Brunswick, GA 31520-4851
Phone (912) 342-7112

60 Exchange St
Suite B1
Richmond Hill, GA 31324-7644
Phone (912) 999-2072

790 Veterans Pkwy
Suite 111
Hinesville, GA 31313-3991
Phone (912) 877-4400

810 Towne Park Dr
Suite 200
Rincon, GA 31326-5167
Phone (912) 826-2533

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.22 of 100Reported as group
Quality
71.46
Promoting interoperability
0
Improvement activities
40
Cost
59.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11674GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tattnall Hospital Company, LLC CurrentSince Jul 3, 2023 Accepting new patients
Optim Orthopedics, LLC CurrentSince Jun 29, 2023 Accepting new patients
Tattnall Hospital Company LLC CurrentSince Jul 3, 2023 Accepting new patients
Optim Orthopedics, LLC CurrentSince Jun 29, 2023 Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company LLC Past Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients

Locations

821 S Main St
Ste C
Baxley, GA 31513
Phone (912) 637-5486

3231 Glynn Ave
Brunswick, GA 31520
Phone (912) 265-9006

242 Industrial Blvd
Dublin, GA 31021
Phone (478) 272-3140

790 Veterans Parkway
Ste 111
Hinesville, GA 31313
Phone (912) 368-3868

961 E Winthrope Ave
Millen, GA 30442
Phone (478) 982-0120

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

119B Victory Dr
Swainsboro, GA 30401
Phone (478) 237-7676

102 Rocky Ford Rd
Sylvania, GA 30467
Phone (912) 564-2155

209 Mims Rd
#A
Sylvania, GA 30467
Phone (912) 564-5236

1724 Old Reynolds St
#B
Waycross, GA 31501

Interoperability endpoints

  • Direct secure messaging: robert.coyle.1@16403.direct.athenahealth.com
  • Direct secure messaging: robert.coyle.2@16403.direct.athenahealth.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 1

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": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1235816158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.