Individual provider Active NPI

Tyler J Randall, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1518319318
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R9535 Issued in TX
Practice address
111 Dallas St
San Antonio, TX 78205
Phone
(330) 994-4463
NPI assigned
Jul 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R9535 TX Primary

Addresses

Primary practice location

111 Dallas St
San Antonio, TX 78205

Mailing address

6300 La Calma Dr
Austin, TX 78752-3843
Phone (330) 994-4463

Other practice location 1

1414 Kuhl Ave # Mp31
Orlando, FL 32806-2008
Phone (407) 237-6329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190417001556 TX Practitioner - Emergency Medicine 5395086490 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9535TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Jul 1, 2025 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Mar 19, 2019 Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

630 W State Highway 71
Bastrop, TX 78602
Phone (737) 881-7400

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

8811 Village Dr
San Antonio, TX 78217
Phone (210) 297-2000

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 3

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1518319318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 LA CALMA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523843",
            "telephone_number": "330-994-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DALLAS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78205",
            "telephone_number": "330-994-4463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 Kuhl Ave # Mp31",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328062008",
            "country_code": "US",
            "telephone_number": "407-237-6329",
            "fax_number": "407-649-3083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "TYLER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R9535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.