NPIMap

Individual provider Active NPI

Tyler Chrystine Fugere, MD

  • Hematology (Internal Medicine) Physician
  • Benton, AR
National Provider Identifier
1720549934
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
E-15619 Issued in AR
Practice address
3 Medical Park Dr Ste 202
Benton, AR 72015-3700
Phone
(501) 507-6035
Fax
(501) 776-9677
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology (Internal Medicine) Physician 207RH0000X E-15619 AR Primary
Internal Medicine Physician 207R00000X E-15619 AR

Addresses

Primary practice location

3 Medical Park Dr Ste 202
Benton, AR 72015-3700

Mailing address

PO Box 749495
Atlanta, GA 30374-9495
Phone (855) 963-2100

Other practice location 1

4301 W Markham St # 634
Little Rock, AR 72205-7101
Phone (501) 686-5162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250709004135 AR Practitioner - Internal Medicine 2769716729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Oncology Partners PAGroup PAC ID 0042569758, 377 clinicians

Practice addresses (Care Compare)

3 Medical Park Dr
Suite 202
Benton, AR 72015-3700
Phone (501) 525-4555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-15619ARMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Oncology Partners PA Hematology CurrentSince Aug 1, 2025 Accepting new patients

Locations

3 Medical Park Dr
Ste 202
Benton, AR 72015
Phone (501) 507-6035

1300 Centerview Dr
Little Rock, AR 72211
Phone (501) 410-1196

130 Medical Cir
Nashville, AR 71852
Phone (501) 624-7700

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1720549934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749495",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749495",
            "telephone_number": "855-963-2100",
            "fax_number": "813-321-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PARK DR STE 202",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153700",
            "telephone_number": "501-507-6035",
            "fax_number": "501-776-9677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 634",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-5162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGERE",
        "first_name": "TYLER",
        "middle_name": "CHRYSTINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "AR",
            "license": "E-15619",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.