Active NPI
Tyler Masters
- Surgery of the Hand (Surgery) Physician
- Warren, MI
National Provider Identifier
1407476971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery of the Hand (Surgery) Physician
- License
- 4351046615
- Practice address
- 11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546 - Phone
- (586) 573-6880
- Fax
- (586) 573-2562
- NPI assigned
- Apr 24, 2020
- Last updated
- Jul 14, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery of the Hand (Surgery) Physician | 2086S0105X | 4351046615 | MI | Primary |
Addresses
Primary practice location
11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Mailing address
31201 Chicago R
Ste C301
Warren, MI 48093
Phone (586) 582-0864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200608002133 | MI | Order and Referring Only - General Surgery | 2062833676 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1407476971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31201 CHICAGO R",
"address_2": "STE C301",
"city": "WARREN",
"state": "MI",
"postal_code": "48093",
"telephone_number": "586-582-0864",
"fax_number": "586-573-2562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11012 E 13 MILE RD STE 112",
"city": "WARREN",
"state": "MI",
"postal_code": "480932546",
"telephone_number": "586-573-6880",
"fax_number": "586-573-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTERS",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0105X",
"taxonomy_group": "",
"desc": "Surgery, Surgery of the Hand",
"state": "MI",
"license": "4351046615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.