Individual provider Active NPI

Tylan Muncy, MD

  • Emergency Medicine Physician
  • Eglin Afb, FL
National Provider Identifier
1609036649
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101246817 Issued in VA
Practice address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone
(850) 883-8600
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101246817 VA Primary

Addresses

Primary practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Mailing address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone (850) 883-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130214000406 VA Practitioner - Emergency Medicine 1254585532 Reassigns benefits to 2 organizations
I20201201000944 FL Practitioner - Emergency Medicine 1254585532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (850) 469-2313

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
93.19
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101246817VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Feb 1, 2016 Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Nov 6, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2016 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Nov 6, 2020 Accepting new patients
Riverside Physician Services, Inc. Emergency Medicine Past Accepting new patients

Locations

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

1500 N 28th St
Richmond, VA 23223
Phone (804) 225-1700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1609036649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCY",
        "first_name": "TYLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101246817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.