Rose Hanna Tyler

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

11001389 Issued in FL

Practice address

3301 66TH St N
St Petersburg, FL 33710-1547

Phone

(727) 344-6200

NPI assigned

Feb 9, 2019

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Promed Ipa LLC

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1457218596
  NPD (past)

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549670400000",
    "number": "1508321969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101547",
            "telephone_number": "727-344-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "ROSE",
        "middle_name": "HANNA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2019-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11001389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Two Front Orthodontics FL, PLLC
• Alexandra Tworek
• Ashok Kumar Tyagi, D.O.
• Delaney Tyl
• Michael Robert Tyler, RPH
• Timara Tyler, LCDC, LMHC
• Tyrone Manor
• Tyrone Square Mall Dental P.a
• George Tyson, M.D.
• Heather M Tyson, APRN

• Primary Care Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.