Tyrone Gary Bristol, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD053658L Issued in PA

Practice address

802 New Holland Ave Ste 100
Lancaster, PA 17602-2288

Phone

(717) 560-3782

Fax

(717) 560-3787

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbristol232821@direct-lghealth.org

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.

• Lancaster General Hospital

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1306961800
  Medicare reassignment NPD
• Lancaster General Medical Group

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1952392383
  Medicare reassignment NPD
• Lanaster General Hospital

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1457067605
  NPD
• Lancaster General Hospital

  • Gastroenterology Physician
  • Lancaster, PA
  • NPI 1205691912
  NPD
• Lancaster General Medical Group

  • Urgent Care Clinic/Center
  • Ephrata, PA
  • NPI 1295000719
  NPD
• Lancaster General Medical Group

  • Obstetrics & Gynecology Physician
  • Lancaster, PA
  • NPI 1306724570
  NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1437150596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE STE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022288",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE STE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022288",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "TYRONE",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD053658L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2013-02294",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "198984",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "11658",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD053658L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD053658L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2031",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437150596",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01697965",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Briley, MD
• Amber L Brill, LMT
• Julianna Brim, M.ED, LBS, BCBA
• Michael Brinkos, LSW
• Brian Thomas Brislin, MD
• Frank Vincent Brizzi, PA-C
• Jerome Broad, CRNA
• John H Broaddus, OD
• Hannah Broadway
• Ashley E. Broberg, LCSW

• Psychiatry Physician in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.

Verify at the official NPI Registry.