Tyler Jeffrey Cardillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0006776 Issued in CO

Practice address

620 S Lemay Ave
Fort Collins, CO 80524-3543

Phone

(970) 221-5811

NPI assigned

Aug 5, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Florida Practitioners, LLC

  • Surgical Physician Assistant
  • Pembroke Pines, FL
  • NPI 1528456548
  Medicare reassignment Care Compare group

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

• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1669027967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 LASSINO CT",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339506524",
            "telephone_number": "941-505-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243543",
            "telephone_number": "970-221-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDILLO",
        "first_name": "TYLER",
        "middle_name": "JEFFREY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0006776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Capraro, LPC
• Joseph M Carabetta, M.D., M.S.
• Carbon Health Medical Group of Florida PA
• Janee Cardenas
• Liillyana Cardenas
• April L Cardwell, DC
• Care of the Mind LLC
• Caregivers North LLC
• Kerrie C. Cargill-Hitchcock, L.C.S.W.
• Lisa Marie Carlet, D.C.

• Physician Assistant in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.