Individual provider Active NPI

Tyler J McCauley, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1285294835
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-007108 Issued in IL
Practice address
1135 W 69TH St
Chicago, IL 60621-1147
Phone
(773) 483-5011
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.007108 IL
Physician Assistant 363A00000X 085-007108 IL Primary

Addresses

Primary practice location

1135 W 69TH St
Chicago, IL 60621-1147

Mailing address

1135 W 69TH St
Chicago, IL 60621-1147
Phone (773) 483-5011

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tyler.mccauley@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MD, DC3 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

Enrollment IDStateProvider typePAC IDDetails
I20191231001386 IL Practitioner - Physician Assistant 7719311695 Reassigns benefits to 1 organization
I20211209000112 MD Practitioner - Physician Assistant 7719311695 Reassigns benefits to 1 organization
I20211209000245 DC Practitioner - Physician Assistant 7719311695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10210 Reisterstown Rd
Owings Mills, MD 21117-3606
Phone (410) 902-6776

1110 Annapolis Rd
Odenton, MD 21113-1602
Phone (443) 351-3917

15459 Annapolis Rd
Bowie, MD 20715-1847
Phone (240) 544-0676

2051 W St
Annapolis, MD 21401-3006
Phone (443) 603-0758

5900 Cedar LN
Columbia, MD 21044-3635
Phone (443) 718-4067

7116 Ritchie Hwy
Glen Burnie, MD 21061-2904
Phone (443) 577-0277

726 Rockville Pike
Rockville, MD 20852-1133
Phone (240) 238-0411

8105 Ritchie Hwy
Pasadena, MD 21122-3905
Phone (443) 573-0564

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.007108ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Dec 13, 2019 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Dec 1, 2021 Accepting new patients
Cook County CurrentSince Dec 13, 2019 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Dec 1, 2021 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1135 W 69th St
Chicago, IL 60621
Phone (773) 483-5011

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: tyler.mccauley@direct.ccprovider.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1285294835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W 69TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211147",
            "telephone_number": "773-483-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W 69TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211147",
            "telephone_number": "773-483-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "TYLER",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.007108",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-007108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.mccauley@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.