Individual provider Active NPI

Tyler Allen Defriece, MD

  • Student in an Organized Health Care Education/Training Program
  • Carmel, NY
National Provider Identifier
1619617479
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
670 Stoneleigh Ave
Carmel, NY 10512-3997
Phone
(845) 790-1321
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 79679 CT
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

670 Stoneleigh Ave
Carmel, NY 10512-3997

Mailing address

670 Stoneleigh Ave
Carmel, NY 10512-3997

Other practice location 1

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251002004727 CT Practitioner - Psychiatry 2062912710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Windham Community Memorial Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
William W Backus Hospital CurrentSince Oct 1, 2025 Accepting new patients
Natchaug Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
The William W Backus Hospital CurrentSince Oct 1, 2025 Accepting new patients

Locations

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Organizations & group practices 4

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 3

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1619617479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 STONELEIGH AVE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 STONELEIGH AVE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123997",
            "telephone_number": "845-790-1321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Storrs Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield Center",
            "state": "CT",
            "postal_code": "062501683",
            "country_code": "US",
            "telephone_number": "860-456-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFRIECE",
        "first_name": "TYLER",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "79679",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.