Tyler John Halstead, PA-C
Individual provider Active NPI Physician Assistant · Nitro, WV
NPI 1730725151 · NPPES record last updated Mar 30, 2026
Key facts
- NPI
- 1730725151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 826 (WV)
- Practice address
- 4111 1St Ave Ste 3
Nitro, WV 25143-1345 - Phone
- (304) 755-4797
- Fax
- (304) 755-4799
- NPI assigned
- Nov 20, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Charleston Area Medical Center Inc
Practice addresses (Care Compare)
2851 Charleston Rd
Suite 2
Poca, WV 25159-7652
Phone (304) 351-3015
314 Goff Mountain Rd
Suite 3
Cross Lanes, WV 25313-6600
Phone (304) 388-7070
400 Association Dr
Suite 102
Charleston, WV 25311-1298
4111 1St Ave
Suite 3
Nitro, WV 25143-1345
Phone (304) 755-4797
501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432
Hospital & facility affiliations
- Charleston Area Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201117001037 | WV | Practitioner - Physician Assistant | 5991116378 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Area Medical Center Inc | Current |
Accepting new patients | |
| Charleston Area Medical Center, Inc. | Current |
Accepting new patients | |
| Charleston Area Medical Center Inc | Past | Accepting new patients |
Locations
501 Morris St
Charleston, WV 25301
Phone (304) 348-6293
3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273
4111 1st Ave
Ste 3
Nitro, WV 25143
Phone (304) 755-4797
Interoperability endpoints
- tyler.halstead@camc.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 826 | WV | Yes |
Addresses
Primary practice location
4111 1St Ave Ste 3
Nitro, WV 25143-1345
Mailing address
4111 1St Ave Ste 3
Nitro, WV 25143-1345
Phone (304) 755-4797
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730725151 | Medicaid | WV |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tyler.halstead@camc.cernerdirect.com |
Other providers in Nitro, WV
- Abigail Renee Grant
- Olin David Green Jr.
- John H Hager
- Tracey Dawn Hager
- Charles Hall
- Courtney Harper
- Rachel Heilmann
- Herbert J Thomas Memorial Hospital Association
- William Elmer Higginbotham
- Hunter Gavin Highlander
All providers in Nitro, WV · Physician Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.