Active NPI
Jack Tyson
- Registered Nurse
- Brooklyn, NY
National Provider Identifier
1770428179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- N32590
- Practice address
- 40 Flatbush Avenue Ext
Brooklyn, NY 11201-2903 - Phone
- (718) 215-1818
- NPI assigned
- Apr 21, 2026
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | N32590 | NY | Primary |
Addresses
Primary practice location
40 Flatbush Avenue Ext
Brooklyn, NY 11201-2903
Mailing address
40 Flatbush Avenue Ext
Brooklyn, NY 11201-2903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1881 SW Naito Pkwy
Portland, OR 97201-5195
356 W 18TH St
New York, NY 10011-4401
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N32590 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1770428179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 FLATBUSH AVENUE EXT",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112012903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 FLATBUSH AVENUE EXT",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112012903",
"telephone_number": "718-215-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSON",
"first_name": "JACK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-21",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "N32590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.