Upstate Surgery PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

22507 Issued in SC

Legal business name

UPSTATE SURGERY PA

Practice address

16 Accountants Cir
Seneca, SC 29678-2670

Phone

(864) 886-9250

Fax

(864) 886-9251

NPI assigned

Dec 23, 2005

Organization subpart

No

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

Authorized official

Name

Bradford A Tyler, M.D.NPI 1932172418

Title

President/Owner

Phone

(864) 886-9250

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradford Alan Tyler, M.D.

  • Surgery Physician
  • Wilmington, NC
  • NPI 1932172418
  NPD (past) Authorized official

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437136108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 834",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296790834",
            "telephone_number": "864-886-9250",
            "fax_number": "864-886-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ACCOUNTANTS CIR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782670",
            "telephone_number": "864-886-9250",
            "fax_number": "864-886-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "864-886-9250",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "SC",
            "license": "22507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T67488",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upstate Homecare MD, LLC
• Upstate Institute of Youth Programs, Inc.
• Upstate Medical Associates PA
• Upstate Pediatric Therapy Co
• Upstate Periodontics and Implantology, LLC
• Van Romer Chiropractic
• Amy Vanatter
• Danielle Varljen
• Nelson Vazquez, OT
• Joyce Vissage, CPNP

• Surgery Physician in Seneca, SC
• Providers in Seneca, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.