Tyler Mautino, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003123 Issued in PA

Practice address

60 Hatch Run Rd
Warren, PA 16365-5249

Phone

(724) 825-3691

Fax

(814) 726-9090

NPI assigned

Oct 12, 2015

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 PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Health Center P CGroup PAC ID 0941248959, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Family Eye Health Center P C

  • Optometrist
  • Bradford, PA
  • NPI 1144380601
  Medicare reassignment Care Compare group NPD
• Erie Vamc

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1396796827
  NPD (past)

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1679944177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HATCH RUN RD",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163655249",
            "telephone_number": "724-825-3691",
            "fax_number": "814-726-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HATCH RUN RD",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163655249",
            "telephone_number": "724-825-3691",
            "fax_number": "814-726-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUTINO",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Markley, MA
• Genine Martin, PA-C
• Julie Ann Martin, PHARMD
• Katlyn Raye Maurer, LPC
• Lindsey Mautino, LPC
• Jennifer Mayhue, LMFT
• Gary Lynn McAfoos, MD
• David M McConnell Jr., M.D.
• Douglas Earl McCracken, APC
• Brian McIntosh, M.D.

• Optometrist in Warren, PA
• Providers in Warren, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.