Tyler Egbert

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7991 Issued in ID

Practice address

429 N Idaho St
Wendell, ID 83355-5050

Phone

(208) 536-3090

Fax

(208) 536-3090

NPI assigned

Sep 8, 2016

Last updated

Nov 29, 2023By 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 ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lon M. Egbert, P.C.Group PAC ID 8224132477, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lon M. Egbert, P.C.

  dba Jerome Physical Therapy & Sports Medicine Clinic

  • Physical Therapist
  • Jerome, ID
  • NPI 1265527725
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1467909317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 EAGLE RIDGE DR",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833553340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N IDAHO ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555050",
            "telephone_number": "208-536-3090",
            "fax_number": "208-536-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 5th Ave W",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833381863",
            "country_code": "US",
            "telephone_number": "280-324-3090",
            "fax_number": "208-324-3093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Donald Brown, PHARMD
• Carefix Management and Consulting, Inc. (Wildwood Assisted Living)
• Jeremiah McKell Funk, DDS
• Independent School District #232
• Jack C. Kulm DMD PA
• K2Red LLC
• Jack C Kulm, DMD PA

• Physical Therapist in Wendell, ID
• Providers in Wendell, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.