NPIMap

Individual provider Active NPI

Tyler Ashley Sullivan, PA-C

  • Physician Assistant
  • Newtown, PA
National Provider Identifier
1760917207
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063056 Issued in PA
Practice address
101 Pheasant Run
Newtown, PA 18940-1820
Phone
(800) 321-9999
Fax
(267) 479-1321
NPI assigned
Apr 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 MA063056 PA Primary

Addresses

Primary practice location

101 Pheasant Run
Newtown, PA 18940-1820

Mailing address

833 Chestnut St Ste 520
Philadelphia, PA 19107-4430
Phone (800) 321-9999

Other names 1

  • Tyler Ashley Rosa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211209000288 PA Practitioner - Physician Assistant 5193094803 Reassigns benefits to 2 organizations
I20230403000179 NJ Practitioner - Physician Assistant 5193094803 Reassigns benefits to 1 organization

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
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Reconstructive Orthopaedic Associates II LLCGroup PAC ID 7416845318, 274 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

925 Chestnut St
FL 5
Philadelphia, PA 19107-4206
Phone (267) 339-3500

Hospital & facility affiliations

  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063056PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Institute of New Jersey, P.a. CurrentSince Feb 18, 2023 Accepting new patients
HR Physician Services CurrentSince Dec 3, 2021 Accepting new patients
HR Physician Services CurrentSince Dec 3, 2021 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jan 16, 2023 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jan 16, 2023 Accepting new patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Feb 18, 2023 Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1650 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 707-7200

1650 Huntingdon Pike
Ste 160
Meadowbrook, PA 19046
Phone (215) 344-9560

1648 Huntingdon Pike
Fl 1
Meadowbrook, PA 19046
Phone (215) 938-2040

101 Pheasant Run
Newtown, PA 18940

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 7

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 4

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": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1760917207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 520",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074430",
            "telephone_number": "800-321-9999",
            "fax_number": "267-479-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PHEASANT RUN",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401820",
            "telephone_number": "800-321-9999",
            "fax_number": "267-479-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TYLER",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "ROSA",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newtown, PA

Sources for this page

Verify at the official NPI Registry.