Tyler Jack Stoots, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9107491 Issued in FL

Practice address

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Phone

(321) 633-3162

Fax

(321) 821-4955

NPI assigned

Jan 20, 2014

Sex

Male

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

Enrolled in FL

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1285735605
  Medicare reassignment Care Compare group
• Brevard Family Walk in Clinic LLC

  • Family Medicine Physician
  • Rockledge, FL
  • NPI 1134146046
  Medicare reassignment
• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  Medicare reassignment
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Port Orange, FL
  • NPI 1174262232
  NPD
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Sebastian, FL
  • NPI 1376421479
  NPD
• Brevard Family Walk in Clinic Rockledge

  • Non-Pharmacy Dispensing Site
  • Rockledge, FL
  • NPI 1265846943
  NPD (past)

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1548682941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 US HIGHWAY 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553763",
            "telephone_number": "321-636-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162",
            "fax_number": "321-821-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOOTS",
        "first_name": "TYLER",
        "middle_name": "JACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-20",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9107491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura A Stefanelli, ARNP
• Nicole Moy Stevens, D.D.S.
• Geneene Minette Stewart, LPN
• Maureen Elizabeth Stewart
• Ryan Luke Stoltzfus, DPT
• Elle Strote
• Danica Marie Stroup
• Brett Stroze, D.C.
• David John Strunk, O.D.
• Jill Stutts, PT, ATC

• Physician Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.

Verify at the official NPI Registry.