Tyler Elliott Dial, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07818 Issued in NC

Practice address

923 W 3Rd St
Pembroke, NC 28372-9628

Phone

(910) 521-0564

Fax

(910) 521-8091

NPI assigned

Jan 23, 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 NC

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precision Health, PCGroup PAC ID 6709260185, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Precision Health, PC

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1396484572
  Medicare reassignment Care Compare group
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1427282045
  Medicare reassignment
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1265165518
  NPD

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

• Southeastern Regional Medical Center

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1689172868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N CEDAR ST STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583926",
            "telephone_number": "910-272-3048",
            "fax_number": "910-738-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 W 3RD ST",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729628",
            "telephone_number": "910-521-0564",
            "fax_number": "910-521-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAL",
        "first_name": "TYLER",
        "middle_name": "ELLIOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanira Delao
• Kaniyah Dhliwayo
• Cynthia Sueann Dial
• Faline Dial, MS, SLP
• Socoria Lee Dial
• Dial'S Family Care Home #1
• Dial'S Family Care Home #2
• Dial'S Family Care Home #3
• Dial'S Family Care Home #4
• Dial'S Family Care Home #5

• Physician Assistant in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.