Individual provider Active NPI

Tyler Thomas Stuebchen, PA-C

  • Physician Assistant
  • East Amherst, NY
National Provider Identifier
1407610769
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031700 Issued in NY
Practice address
8750 Transit Rd
East Amherst, NY 14051-2610
Phone
(716) 250-9999
NPI assigned
Feb 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 031700 NY
Physician Assistant 363A00000X 031700 NY Primary

Addresses

Primary practice location

8750 Transit Rd
East Amherst, NY 14051-2610

Mailing address

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240506000055 NY Practitioner - Physician Assistant 0749620912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

10195 Niagara Falls Blvd
Suite 100
Niagara Falls, NY 14304-2941
Phone (716) 250-9999

260 Red Tail Rd
Orchard Park, NY 14127-1562
Phone (716) 250-9999

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

8750 Transit Rd
East Amherst, NY 14051-2610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031700NYMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Mar 28, 2024 Accepting new patients

Locations

4020 Sheridan Dr
Amherst, NY 14226

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

10195 Niagara Falls Blvd
#100
Niagara Falls, NY 14304

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

Interoperability endpoints

  • Direct secure messaging: tstuebchen@excelsiorortho.medentdirect.com

Organizations & group practices 2

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 6

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1407610769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 TRANSIT RD",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512610",
            "telephone_number": "716-250-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUEBCHEN",
        "first_name": "TYLER",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "031700",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.