Individual provider Active NPI

Tyler James Trobetsky

  • Medical Physician Assistant
  • Allentown, PA
National Provider Identifier
1356082598
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA063854 Issued in PA
Practice address
1621 N Cedar Crest Blvd
Allentown, PA 18104-2304
Phone
(610) 402-8900
NPI assigned
Apr 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA063854 PA Primary

Addresses

Primary practice location

1621 N Cedar Crest Blvd
Allentown, PA 18104-2304

Mailing address

2100 Mack Blvd
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

4170 City Ave
Philadelphia, PA 19131-1610
Phone (215) 871-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221012004127 PA Practitioner - Physician Assistant 4880060094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1503 N Cedar Crest Blvd
LVH Hospitalist PGRM
Allentown, PA 18104-2310
Phone (610) 861-8080

1621 N Cedar Crest Blvd
Allentown, PA 18104-2304

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2300 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 402-6164

2310 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 691-6248

334 Main St
Dickson City, PA 18519-1668
Phone (570) 307-1767

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Dickson City Hospital, Dickson City, PA, CCN 390338
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2022 Accepting new patients
Hazleton Professional Services CurrentSince Dec 5, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2022 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1621 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 402-3300

111 Switzgabel Dr
Brodheadsville, PA 18322
Phone (570) 369-1004

26 Station Cir
Hazleton, PA 18202
Phone (570) 861-8710

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

1120 Oak St
Pittston Township, PA 18640
Phone (570) 299-3384

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

334 Main St
Scranton, PA 18519
Phone (570) 307-1767

241 Claremont Ave
Tamaqua, PA 18252
Phone (570) 225-7211

1411 Jacobsburg Rd
Wind Gap, PA 18091
Phone (484) 861-0493

Interoperability endpoints

  • Direct secure messaging: ttrobetsky712791@direct2.lvhn.org

Organizations & group practices 5

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 10

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": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1356082598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 N CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042304",
            "telephone_number": "610-402-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311610",
            "country_code": "US",
            "telephone_number": "215-871-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROBETSKY",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-03",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA063854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.