Tyler David Owitz, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

349957 Issued in NY

Practice address

9 Ava Maria Dr
Phoenicia, NY 12464-5102

Phone

(845) 338-7140

Fax

(845) 338-7141

NPI assigned

Sep 27, 2022

Last updated

Sep 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Associates of the Hudson Valley

  • Infectious Disease Physician
  • Kingston, NY
  • NPI 1700966801
  Medicare reassignment NPD
• Medical Associates of the Hudson Valley

  • Family Medicine Physician
  • Phoenicia, NY
  • NPI 1720846439
  NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1467176248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 AVA MARIA DR",
            "city": "PHOENICIA",
            "state": "NY",
            "postal_code": "124645102",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Elwyn Ln",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "NY",
            "postal_code": "124981301",
            "country_code": "US",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWITZ",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin Connelly, PH.D.
• Martin Krakower, M.D.
• Susan Jean Lennon
• Medical Associates of the Hudson Valley
• Josette Elizabeth Muellerleile, PHARMD
• Pharmacy for the Public Good, Inc. (Wellness RX)
• Pharmacy for the Public Good, Inc.
• Phoenicia Pharmacy
• Julia Rose, L,AC
• Mary Ellen Schneider, LCSW

• Family Nurse Practitioner in Phoenicia, NY
• Providers in Phoenicia, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.