NPIMap

Individual provider Active NPI

Tyler Novotney

  • Physician Assistant
  • Martinsville, VA
National Provider Identifier
1609313352
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-005627 Issued in VA
Practice address
320 Hospital Dr
Martinsville, VA 24112-1900
Phone
(276) 666-7394
Fax
(276) 666-7866
NPI assigned
Jan 19, 2017
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 0110-005627 VA Primary

Addresses

Primary practice location

320 Hospital Dr
Martinsville, VA 24112-1900

Mailing address

15059 N Scottsdale Rd
Suite 600
Scottsdale, AZ 85254-2379
Phone (602) 778-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170315001276 VA Practitioner - Physician Assistant 6406131382 Reassigns benefits to 1 organization
I20180430001990 PA Practitioner - Physician Assistant 6406131382 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahn Hospitalist Group LTDGroup PAC ID 1153543251, 69 clinicians

Practice addresses (Care Compare)

1301 Carlisle St
Natrona Heights, PA 15065-1152
Phone (724) 224-5100

2 W Crescent Park
Warren, PA 16365-2111
Phone (814) 726-2510

835 Hospital Rd
Indiana, PA 15701-3629
Phone (724) 357-7121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.54 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

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

Hospital & facility affiliations 1

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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1609313352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15059 N SCOTTSDALE RD",
            "address_2": "SUITE 600",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542379",
            "telephone_number": "602-778-3600",
            "fax_number": "602-778-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 HOSPITAL DR",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121900",
            "telephone_number": "276-666-7394",
            "fax_number": "276-666-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNEY",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-005627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.