Individual provider Active NPI

Ty Crouch, DC

  • Chiropractor
  • Port St Lucie, FL
National Provider Identifier
1477400455
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15834 Issued in FL
Practice address
1680 SE Lyngate Dr
Port St Lucie, FL 34952-4300
Phone
(772) 773-7055
NPI assigned
Mar 11, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15834 FL Primary

Addresses

Primary practice location

1680 SE Lyngate Dr
Port St Lucie, FL 34952-4300

Mailing address

3038 Sunrise Blvd
Fort Pierce, FL 34982-6113
Phone (772) 979-4615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260328000502 FL Practitioner - Chiropractic 4688159569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Royal Palm Beach Rehab, CorpGroup PAC ID 3476683335, 62 clinicians

Practice addresses (Care Compare)

1680 SE Lyngate Dr
Port Saint Lucie, FL 34952-4300
Phone (772) 242-7720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15834FLMDMusic Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1477400455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3038 SUNRISE BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349826113",
            "telephone_number": "772-979-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SE LYNGATE DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524300",
            "telephone_number": "772-773-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "TY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "15834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.