Individual provider Active NPI

Nancy Tyre

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1366465734
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G56060 Issued in CA
Practice address
1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone
(310) 319-4700
Fax
(310) 453-7578
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G56060 CA Primary

Addresses

Primary practice location

1920 Colorado Ave
Santa Monica, CA 90404-3414

Mailing address

5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 319-4709

Other identifiers 1

IdentifierTypeStateIssuer
00G560600MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051109000615 CA Practitioner - Family Practice 1850319740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 9739083866, 36 clinicians

Practice addresses (Care Compare)

1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone (310) 319-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.7 of 100Reported as group
Quality
82.59
Promoting interoperability
100
Improvement activities
40
Cost
65.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G56060CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Family Medicine CurrentSince Mar 11, 2009 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

1920 Colorado Ave
Santa Monica, CA 90404
Phone (310) 319-4700

1920 Colorado Ave
Fl Second
Santa Monica, CA 90404

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ntyre53542@direct.uclahealth.org

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1366465734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-319-4709",
            "fax_number": "310-453-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 COLORADO AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043414",
            "telephone_number": "310-319-4700",
            "fax_number": "310-453-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRE",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G56060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G560600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.