Active NPI
Tyler Joseph Branco, PA-C
- Medical Physician Assistant
- Wilbraham, MA
National Provider Identifier
1467975151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA6199
- Practice address
- 2344 Boston Rd
Wilbraham, MA 01095-1104 - Phone
- (413) 596-5550
- Fax
- (413) 794-2551
- NPI assigned
- Jul 25, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA6199 | MA | Primary |
Addresses
Primary practice location
2344 Boston Rd
Wilbraham, MA 01095-1104
Mailing address
280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171101001782 | MA | Practitioner - Physician Assistant | 0042586323 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Baystate Medical Practices Inc
Practice addresses (Care Compare)
2344 Boston Rd
Wilbraham, MA 01095-1104
Phone (413) 596-5550
280 Chestnut St
Suite 2
Springfield, MA 01199-1001
759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439
Hospital & facility affiliations
- Elara Caring
- Baystate Home Health
- Baystate Medical Center
- Baystate Wing Hospital
- Baystate Noble Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA6199 | MA | MD | Medical Physician Assistant |
Organizations & group practices 1
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
MA
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Westfield, MA
- NPI 1700816048
Hospital
-
- Home Health Agency
- Braintree, MA
- NPI 1417934654
-
- Home Health Agency
- West Springfield, MA
- NPI 1104897735
-
- Community Based Hospice Care Agency
- West Springfield, MA
- NPI 1437139664
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1467975151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 CHESTNUT ST FL 2",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011991001",
"telephone_number": "413-794-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2344 BOSTON RD",
"city": "WILBRAHAM",
"state": "MA",
"postal_code": "010951104",
"telephone_number": "413-596-5550",
"fax_number": "413-794-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCO",
"first_name": "TYLER",
"middle_name": "JOSEPH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-25",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "PA6199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilbraham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.
- 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.