Active NPI
Tyler Andres, PTA
- Physical Therapy Assistant
- Troy, MI
National Provider Identifier
1760253686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5502008318
- Practice address
- 3339 Rochester Rd
Troy, MI 48083-5454 - Phone
- (248) 918-4966
- NPI assigned
- Jan 10, 2024
- Last updated
- Jan 10, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502008318 | MI | Primary |
Addresses
Primary practice location
3339 Rochester Rd
Troy, MI 48083-5454
Mailing address
20191 Broadacres St
Clinton Township, MI 48035-4009
Phone (586) 855-8820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502008318 | MI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHS HC LLC | Current | Accepting new patients |
Locations
3339 Rochester Rd
Troy, MI 48083
Phone (248) 918-4966
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1760253686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20191 BROADACRES ST",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480354009",
"telephone_number": "586-855-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3339 ROCHESTER RD",
"city": "TROY",
"state": "MI",
"postal_code": "480835454",
"telephone_number": "248-918-4966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRES",
"first_name": "TYLER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-10",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502008318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.