Individual provider Active NPI

Tyler Lange, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1407526197
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029384 Issued in OH
Practice address
3436 Granite Cir
Toledo, OH 43617-1160
Phone
(419) 887-8710
NPI assigned
Sep 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0029384 OH Primary

Addresses

Primary practice location

3436 Granite Cir
Toledo, OH 43617-1160

Mailing address

3436 Granite Cir
Toledo, OH 43617-1160
Phone (419) 887-8710

Other practice location 1

5901 Monclova Rd
Maumee, OH 43537-1841
Phone (419) 893-5911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 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
I20211116002420 OH Practitioner - Nurse Practitioner 2769871516 Reassigns benefits to 4 organizations
I20231005001448 MI Practitioner - Nurse Practitioner 2769871516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Northwest Ohio, Inc.Group PAC ID 3375456478, 102 clinicians
The Toledo HospitalGroup PAC ID 2961309638, 118 clinicians
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 228-3335

1075 Medical Ctr Pkwy
Maumee, OH 43537
Phone (567) 585-0800

5308 Harroun Rd
Suite 160
Sylvania, OH 43560-2174
Phone (419) 824-5668

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8400

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

Merit-based Incentive Payment System (MIPS)

Final score
99.25 of 100Reported as group
Quality
96.55
Improvement activities
40
Cost
89.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
The Toledo Hospital Current Accepting new patients
Promedica Central Physicians CurrentSince Mar 4, 2026 Accepting new patients
The Toledo Hospital CurrentSince Feb 1, 2024 Accepting new patients
Promedica Central Physicians CurrentSince Mar 4, 2026 Accepting new patients
The Toledo Hospital CurrentSince Feb 1, 2024 Accepting new patients
Observation Physicians of Northwest Ohio LLC CurrentSince Sep 1, 2023 Accepting new patients
Emergency Physicians of Northwest Ohio Inc. CurrentSince Sep 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

5705 Monclova Rd
Maumee, OH 43537
Phone (419) 893-3321

1075 Medical Center Pkwy
Maumee, OH 43537
Phone (567) 585-0800

5308 Harroun Rd
Ste 160
Sylvania, OH 43560
Phone (419) 824-5668

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

3436 Granite Cir
Toledo, OH 43617
Phone (419) 291-0101

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 10

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 5

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1407526197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 GRANITE CIR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171160",
            "telephone_number": "419-887-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 GRANITE CIR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171160",
            "telephone_number": "419-887-8710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 Monclova Rd",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435371841",
            "country_code": "US",
            "telephone_number": "419-893-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.