Individual provider Active NPI

Timothy Edgar Marcyes, P.A.

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1568550887
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03663 Issued in TX
Practice address
1814 Roseland Blvd
Second Floor, Suite 200
Tyler, TX 75701-4234
Phone
(903) 531-2500
Fax
(903) 595-3785
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03663 TX Primary

Addresses

Primary practice location

1814 Roseland Blvd
Second Floor, Suite 200
Tyler, TX 75701-4234

Mailing address

P O Box 130459
Tyler, TX 75713-0459
Phone (903) 531-2500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060419000187 TX Practitioner - Physician Assistant 9133138159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Pain InstituteGroup PAC ID 1951363712, 4 clinicians

Practice addresses (Care Compare)

907 E Eureka St
Suite B
Weatherford, TX 76086-5880

907 Eureka St
Suite B
Weatherford, TX 76086-5880
Phone (817) 599-4901

Merit-based Incentive Payment System (MIPS)

Final score
89.13 of 100Reported as individual
Quality
90.1
Improvement activities
40
Cost
71.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Pain Center, PLLC Past Accepting new patients
Central Texas Pain Institute PLLC PastSince Nov 12, 2012 Accepting new patients

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1568550887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 130459",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757130459",
            "telephone_number": "903-531-2500",
            "fax_number": "903-595-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "address_2": "SECOND FLOOR, SUITE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-531-2500",
            "fax_number": "903-595-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCYES",
        "first_name": "TIMOTHY",
        "middle_name": "EDGAR",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.