Individual provider Active NPI

Tayler Grybowski

  • Physician Assistant
  • Brandon, FL
National Provider Identifier
1356947949
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
615 Vonderburg Dr
Brandon, FL 33511-5972
Phone
(813) 684-2663
Fax
(813) 658-6222
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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 Primary

Addresses

Primary practice location

615 Vonderburg Dr
Brandon, FL 33511-5972

Mailing address

615 Vonderburg Dr
Brandon, FL 33511-5972
Phone (813) 684-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220126000843 PA Practitioner - Physician Assistant 7416369228 Reassigns benefits to 2 organizations
I20220526000775 OH Practitioner - Physician Assistant 7416369228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Dutch Ridge Rd
Beaver, PA 15009-9727
Phone (724) 773-6403

1030 Beaner Hollow Rd
Beaver, PA 15009-9723
Phone (724) 775-4545

500 Sharon Rd
Beaver, PA 15009-1957
Phone (724) 728-8751

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group Inc. CurrentSince May 30, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2022 Accepting new patients
Heritage Valley Medical Group, Inc. Past Accepting new patients

Locations

9 Galen St
Watertown, MA 02472
Phone (617) 562-5413

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

951 Male Rd
Wind Gap, PA 18091
Phone (610) 654-1000

Interoperability endpoints

  • Direct secure messaging: tayler.grybowski.2@33638.direct.athenahealth.com
  • Direct secure messaging: taylergrybowski@hvhs.allscriptsdirect.net

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 3

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": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1356947949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115972",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115972",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYBOWSKI",
        "first_name": "TAYLER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.