Tyler Tanaka

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61867 Issued in OR

Practice address

303 S 5TH St Ste 140
Springfield, OR 97477-5480

Phone

(541) 625-0191

NPI assigned

Aug 10, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Convergence Physical Therapy and Performance

  • Physical Therapy Clinic/Center
  • Springfield, OR
  • NPI 1184221335
  NPD Authorized official
• Train Boston Physical Therapy, Inc.

  • Exclusive Provider Organization
  • Wellesley, MA
  • NPI 1053710467
  NPD (past)

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616198400000",
    "number": "1558815225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W 37TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974053312",
            "telephone_number": "541-263-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S 5TH ST STE 140",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974775480",
            "telephone_number": "541-625-0191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Washington St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024811934",
            "country_code": "US",
            "telephone_number": "781-263-9993",
            "fax_number": "781-263-9996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2021-03-20",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22642",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nayrouz Talua, D.D.S
• Frankie Suzanne Tamblyn, QMHA-R
• Tami S Gerstner MD PC
• Laura Sherril Tamkin
• Lina Tamrakar
• Chelsea Tang, PA
• Rebecca Tansey, D.M.D.
• Tapestry Counseling LLC
• Scotlyn Tarpley
• Julia Davis Taylor, OTR/L

• Physical Therapist in Springfield, OR
• Providers in Springfield, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.