Individual provider Active NPI

Tyler Vinson, DPT

  • Physical Medicine & Rehabilitation Physician
  • Saratoga, CA
National Provider Identifier
1548818412
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
297320 Issued in CA
Practice address
18780 Cox Ave
Saratoga, CA 95070-4109
Phone
(408) 973-7700
Fax
(408) 973-1600
NPI assigned
Sep 3, 2019
Last updated
Sep 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 297320 CA Primary

Addresses

Primary practice location

18780 Cox Ave
Saratoga, CA 95070-4109

Mailing address

18780 Cox Ave
Saratoga, CA 95070-4109
Phone (408) 973-7700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191002000980 CA Practitioner - Physical Therapist in Private Practice 7810227014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agile Physical Therapy IncGroup PAC ID 2163311556, 48 clinicians

Practice addresses (Care Compare)

3825 El Camino Real
Palo Alto, CA 94306-3324
Phone (650) 565-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
297320CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optm Physical Therapy of Saratoga, Inc. CurrentSince Sep 3, 2019 Accepting new patients
Agile Physical Therapy Inc CurrentSince May 25, 2022 Accepting new patients
California Luna Care Physical Therapy PC CurrentSince Apr 8, 2022 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

3825 El Camino Real
Palo Alto, CA 94306
Phone (856) 296-2860

801 N San Mateo Dr
San Mateo, CA 94401

12930 Saratoga Ave
Ste B5
Saratoga, CA 95070
Phone (408) 763-4905

18780 Cox Ave
Saratoga, CA 95070
Phone (408) 370-7303

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1548818412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18780 COX AVE",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704109",
            "telephone_number": "408-973-7700",
            "fax_number": "408-973-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 COX AVE",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704109",
            "telephone_number": "408-973-7700",
            "fax_number": "408-973-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "297320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.