Theodore I Tyberg, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

127630 Issued in NY

Practice address

425 E 61St St
6TH Floor
New York, NY 10065-8795

Phone

(212) 752-2000

Fax

(212) 752-5822

NPI assigned

Oct 10, 2005

Last updated

Mar 18, 2008By 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 2

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• New York Cardiology Associates, P.C.

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1740278795
  Authorized official Same address or phone

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1538157011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 61ST ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658795",
            "telephone_number": "212-752-2000",
            "fax_number": "212-752-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 61ST ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658795",
            "telephone_number": "212-752-2000",
            "fax_number": "212-752-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYBERG",
        "first_name": "THEODORE",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "127630",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "127630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3592993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "NY9721",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6603052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jochebed-Anna Twumasi
• Ty Eyeworks, Inc. (Cohen's Fashion Optical)
• Priya Tyagaraj, PHARMD
• Aanchal Tyagi, DO
• Renuka Tyagi, MD
• Benjamin Tycko, M.D., PH.D.
• Susan Tye, MSW
• Tyka Holdings Inc (Tyka Pharmacy)
• Allison Tylek
• Tyler Allen Conner, Mental Health Counselor, PLLC (ThirdSpace Psychotherapy)

• Cardiovascular Disease Physician in New York, NY
• Providers in New York, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.