Tyler David Ballard, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601008839 Issued in MI

Practice address

2070 E Hill Rd
Grand Blanc, MI 48439-5108

Phone

(810) 695-5353

Fax

(810) 695-0616

NPI assigned

Sep 26, 2018

Sex

Male

Sole proprietor

No

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 MI

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tylerballard@pmi.allscriptsdirect.net
• Direct secure messaging: tballard1116143@direct.hfhs.org

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.

• Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Burton, MI
  • NPI 1598248718
  Medicare reassignment Care Compare group
• Midmichigan Health Services

  • Federally Qualified Health Center (FQHC)
  • Houghton Lake, MI
  • NPI 1912998287
  Medicare reassignment NPD
• Henry Ford Medical Group Genesys

  • Physical Therapist
  • Burton, MI
  • NPI 1114495793
  NPD
• Midmichigan Health Services

  • Federally Qualified Health Center (FQHC)
  • Beaverton, MI
  • NPI 1164262721
  NPD
• Genesys Integrated Group Practice PC

  • Nurse Practitioner
  • Flint, MI
  • NPI 1386782381
  NPD (past)

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1679058630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395108",
            "telephone_number": "810-695-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395108",
            "telephone_number": "810-695-5353",
            "fax_number": "810-695-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601008839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodora Balaj, MD
• Balance Physical Therapy and Wellness LLC
• Felicia Baldassare
• Jennifer J Bales
• Eric Ballard, DO
• Kristina Marie Banaszewski, FNP-C
• Michael Robert Banks
• Fady Banno, MD, MS
• Judith Banta
• Kelly Baran, PTA

• Medical Physician Assistant in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.