Individual provider Active NPI

Thom L. Tyler,, MD, P.A.

  • Gynecology Physician
  • Gainesville, FL
National Provider Identifier
1780682054
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME36132 Issued in FL
Practice address
6440 W Newberry Rd
Suite 408
Gainesville, FL 32605-4381
Phone
(352) 333-5000
Fax
(352) 333-5006
NPI assigned
Jul 12, 2005
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME36132 FL Primary

Addresses

Primary practice location

6440 W Newberry Rd
Suite 408
Gainesville, FL 32605-4381

Mailing address

6440 W Newberry Rd
Suite 408
Gainesville, FL 32605-4381
Phone (352) 333-5000

Other identifiers 1

IdentifierTypeStateIssuer
066787100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120001187 FL Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 6204015381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME36132FLMDGynecology Physician

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1780682054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY RD",
            "address_2": "SUITE 408",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054381",
            "telephone_number": "352-333-5000",
            "fax_number": "352-333-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY RD",
            "address_2": "SUITE 408",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054381",
            "telephone_number": "352-333-5000",
            "fax_number": "352-333-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER,",
        "first_name": "THOM",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD, P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME36132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066787100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.