Individual provider Active NPI

Tyler Andrew Coakley, FNP-C

  • Primary Care Nurse Practitioner
  • Forest Hill, MD
National Provider Identifier
1679347546
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R223324 Issued in MD
Practice address
2 Colgate Dr Ste 103
Forest Hill, MD 21050-2623
Phone
(410) 420-0161
NPI assigned
Nov 13, 2023
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R223324 MD Primary

Addresses

Primary practice location

2 Colgate Dr Ste 103
Forest Hill, MD 21050-2623

Mailing address

2021 Whiteford Rd
Whiteford, MD 21160-1403
Phone (443) 655-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20240105000859 MD Practitioner - Nurse Practitioner 9537510318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

2227 Old Emmorton Rd
220 Mmgii at Smaldore
Bel Air, MD 21015-6189
Phone (410) 569-9040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Primary Care,LLC CurrentSince Jan 3, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

2227 Old Emmorton Rd
Ste 220
Bel Air, MD 21015
Phone (410) 569-9040

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

2 Colgate Dr
Ste 103
Forest Hill, MD 21050
Phone (410) 420-0161

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

2027 Pulaski Hwy
Ste 203
Hvre de Grace, MD 21078
Phone (410) 658-4099

415 Market St
Hvre de Grace, MD 21078
Phone (410) 939-5500

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

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

Hospital & facility affiliations 4

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1679347546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 WHITEFORD RD",
            "city": "WHITEFORD",
            "state": "MD",
            "postal_code": "211601403",
            "telephone_number": "443-655-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLGATE DR STE 103",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502623",
            "telephone_number": "410-420-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY",
        "first_name": "TYLER",
        "middle_name": "ANDREW",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R223324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

Verify at the official NPI Registry.