Tyler David Phelan

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4042 Issued in CT

Practice address

20 York St
New Haven, CT 06510-3220

Phone

(530) 219-9097

NPI assigned

Mar 15, 2018

Last updated

Mar 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1447753421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 GEORGE ST APT 110",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573591",
            "telephone_number": "530-219-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "530-219-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duy Phan
• Julia Phan
• Mi Phan
• Nathan Phan, MD
• Uma Padhye Phatak, MD
• Emma Sandra Philbin, MS, RD, CDN
• Philip M Perrino P.C. (royal vision associates or durham family eye care)
• Andre Gabriel Philipp, APRN
• Monica Slinkard Philipp, APRN
• Robin Lee Phillips, APRN

• Medical Physician Assistant in New Haven, CT
• Providers in New Haven, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.