Tyler Gregory Rose, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01345 Issued in RI

Practice address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone

(401) 456-2121

NPI assigned

Jun 18, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662
  Medicare reassignment Care Compare group
• Emergency Care Services of New England PC

  • Emergency Medicine Physician
  • North Providence, RI
  • NPI 1639537335
  Medicare reassignment
• Affinity Physicians LLC

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053038471
  NPD
• Lifespan Physician Group of Massachusetts Inc

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713
  NPD (past)
• Saint Anne'S Hospital

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1932298296
  NPD (past)

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

• Kent County Memorial Hospital

  • Rehabilitation Hospital Unit
  • Warwick, RI
  • NPI 1023017944
  Care Compare affiliation
• Kent County Memorial Hospital

  • General Acute Care Hospital
  • Warwick, RI
  • NPI 1386643294
  Care Compare affiliation

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1386213916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 EAST AVE # 3F",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028607606",
            "telephone_number": "860-575-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TYLER",
        "middle_name": "GREGORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-18",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisbeth Rosario, LCSW
• Craig Edward Rose, MD
• Derrell Colby Rose
• Erin Elizabeth Rose, FNP-C
• Jonathan Rose, M.D.
• Barbara A Rosen, LICSW
• Dana Rosen, PHD
• Karen Joanne Rosen, M.D.
• Elise Rosenberg Su, MD
• Harry Joseph Rosenberg, MD, PHD

• Physician Assistant in Providence, RI
• Providers in Providence, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.