Tyler T Dewhurst, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3829 Issued in CT

Practice address

216 Hemlock Ave
South Windsor, CT 06074-9606

Phone

(860) 471-8030

NPI assigned

Jul 27, 2006

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Impact Health P.C.

  • Nurse Practitioner
  • Orange, CT
  • NPI 1730694316
  Medicare reassignment Care Compare group NPD
• Dewhurst Medicalservices, Inc.

  • Nurse Practitioner
  • Miami Beach, FL
  • NPI 1528257276
  NPD (past) Authorized official
• Arnold M Koff, MD (Dda Avon Health

  • Cardiovascular Disease Physician
  • Avon, CT
  • NPI 1437436177

  Family

  NPD (past)
• Johnson Professional Associates, PC

  • Hospitalist Physician
  • Stafford Springs, CT
  • NPI 1770564262
  NPD (past)
• Ma Emergency Associates PL

  • Emergency Medicine Physician
  • Miami, FL
  • NPI 1295831584
  NPD (past)

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

• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1336153386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MAPLE DRIVE",
            "city": "TWIN MOUNTAIN",
            "state": "NH",
            "postal_code": "03595",
            "telephone_number": "603-915-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 HEMLOCK AVE",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060749606",
            "telephone_number": "860-471-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWHURST",
        "first_name": "TYLER",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "3829",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3124292",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "003829",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "3829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdewhurst59826@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Saint Francis Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "216 Hemlock Ave",
            "city": "South Windsor",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060749606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dental Team of South Windsor
• Michele M Dery
• Amy Destro, LCSW
• Anna C Devitt, MSN, FNP-BC, APNP
• Rebecca Dewald
• Heather Ann Dibiaso, OTR
• Lauren Dickson, PHARMD
• Amanda Ditomaso, CCC-SLP
• Andrea G. Dixon, MD
• Cassandra Doughty

• Family Nurse Practitioner in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.