Lawrence R Tyler, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601007215 Issued in MI

Practice address

1815 Henson Ave
Kalamazoo, MI 49048-1510

Phone

(269) 492-6500

Fax

(269) 492-6461

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Hans Zwart, M.D. and Associates, Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kettering, OH
  • NPI 1174578447
  NPD (past)
• Premier Health Specialists Inc

  dba Advanced Ankle and Foot Specialists

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1447299789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1400",
            "fax_number": "239-424-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HENSON AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481510",
            "telephone_number": "269-492-6500",
            "fax_number": "269-492-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4771 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339071317",
            "country_code": "US",
            "telephone_number": "239-343-9800",
            "fax_number": "239-343-9848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "LAWRENCE",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9108308",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50-00-0236",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601007215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447299789",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Turner, PT
• Andrew Tuttle
• Lacey Twardowski
• Twenty Hands, LLC.
• Joana Nana Konadu Twum
• Tracey Pogue Tyler, M. A.
• Valerie Tyran
• Amber Amber Tyria, LLBSW
• Brittany Rochelle Tyson
• U Thrive

• Surgical Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.