Tyler Romero, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801116251 Issued in MI

Practice address

4010 Central Ave
St Petersburg, FL 33711-1239

Phone

(727) 327-7656

Fax

(727) 322-2130

NPI assigned

Sep 16, 2022

Last updated

May 15, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairsky FoundationGroup PAC ID 2769775386, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyler.romero.p1@direct.cherryhealth.nextgenshare.com

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.

• Fairsky Foundation

  • Multi-Specialty Clinic/Center
  • Ferndale, MI
  • NPI 1033595665

  Clinical

  Medicare reassignment Care Compare group NPD
• Cherry Street Services, Inc.

  dba Cherry Street Health Services

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1558459164

  Mental Health

  Medicare reassignment NPD
• Cherry Street Services, Inc

  dba Cherry Health - Tri County Middle School

  • Federally Qualified Health Center (FQHC)
  • Howard City, MI
  • NPI 1831955251

  Mental Health

  NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1679295539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337330970",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111239",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "TYLER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberlykellog@suncoastcenter.org",
            "affiliation": "N",
            "address_1": "4010 Central Ave",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337111239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott M Rolston, APRN
• Bliven Szakacsy Roman, APRN
• Mindy Ley Romanov, PA
• Jennifer Romero, MS
• Teresa C Romero
• Laurie Ann Romig, MD
• Ronald H Copenhaver DMD PA (Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery)
• Cristina Rondolino, A.R.N.P.
• Nancy Miquelina Rondon, BA
• Kathleen Rooney-Otero, MD

• Clinical Social Worker in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.