Individual provider Active NPI

Tyler S. Proper, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1699204511
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA059025 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
Jun 5, 2017
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059025 PA Primary

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

111 S Front St
Harrisburg, PA 17101-2010

Other practice location 1

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 231-8772

Other practice location 2

4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone (717) 231-8772

Other identifiers 1

IdentifierTypeStateIssuer
103305000MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tproper55303@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170711000599 PA Practitioner - Physician Assistant 0840569612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Observation Services LLCGroup PAC ID 9537481528, 23 clinicians

Practice addresses (Care Compare)

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3380

4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone (717) 231-8976

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA059025PAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: tproper300022@upmc.direct-ci.com
  • Direct secure messaging: tproper55303@phsdirect.pinnaclehealth.org

Organizations & group practices 2

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 7

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1699204511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1995 Technology Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170508522",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Londonderry Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171095317",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROPER",
        "first_name": "TYLER",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103305000",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tproper55303@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.