Individual provider Active NPI

Tyler Keith Deblieux, MD

  • Otolaryngology Physician
  • Savannah, GA
National Provider Identifier
1295154748
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
82337 Issued in GA
Practice address
5356 Reynolds St Ste 505
Savannah, GA 31405-6017
Phone
(912) 356-1515
Fax
(912) 644-0755
NPI assigned
Apr 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 82337 GA Primary

Addresses

Primary practice location

5356 Reynolds St Ste 505
Savannah, GA 31405-6017

Mailing address

5356 Reynolds St Ste 505
Savannah, GA 31405-6017
Phone (912) 356-1515

Other practice location 1

1250 E. Marshall St.
Box 980146
Richmond, VA 23298
Phone (804) 628-4368

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903001243 GA Practitioner - Otolaryngology 8022337922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in New Orleans, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Candler ENT Practice LLCGroup PAC ID 7214157742, 7 clinicians

Practice addresses (Care Compare)

5356 Reynolds St
Suite 505
Savannah, GA 31405-6017
Phone (912) 356-1515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82337GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Candler ENT Practice, LLC Otolaryngology CurrentSince Aug 1, 2019 Accepting new patients
Georgia Ear Associates PC Past Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 210
Pooler, GA 31322

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

5356 Reynolds St
Ste 505
Savannah, GA 31405

Interoperability endpoints

  • Direct secure messaging: tdeblieux@gent2091.srs-direct.com
  • Direct secure messaging: drdeblieux@direct.sjchs.org

Organizations & group practices 2

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 2

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1295154748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5356 REYNOLDS ST STE 505",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056017",
            "telephone_number": "912-356-1515",
            "fax_number": "912-644-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 REYNOLDS ST STE 505",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056017",
            "telephone_number": "912-356-1515",
            "fax_number": "912-644-0755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E. Marshall St.",
            "address_2": "Box 980146",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "23298",
            "country_code": "US",
            "telephone_number": "804-628-4368",
            "fax_number": "804-828-8299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBLIEUX",
        "first_name": "TYLER",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "82337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.