Individual provider Active NPI

Tyler Crossley

  • Anesthesiology Physician
  • Providence, UT
National Provider Identifier
1821658014
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13166124-1204 Issued in UT
Practice address
560 W 465 N Ste 604
Providence, UT 84332-8006
Phone
(435) 753-1600
Fax
(435) 753-9521
NPI assigned
Jun 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13166124-1204 UT Primary

Addresses

Primary practice location

560 W 465 N Ste 604
Providence, UT 84332-8006

Mailing address

560 W 465 N Ste 604
Providence, UT 84332-8006
Phone (435) 753-1600

Other identifiers 1

IdentifierTypeStateIssuer
1821658014MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20230714001279 UT Practitioner - Anesthesiology 5597091249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interwest Anesthesia Associates LLCGroup PAC ID 0042293359, 29 clinicians

Practice addresses (Care Compare)

500 E 1400
Logan, UT 84341
Phone (435) 716-1000

Hospital & facility affiliations

  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
  • Cache Valley Hospital Hospital, North Logan, UT, CCN 460054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
94-09936KSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interwest Anesthesia Associates LLC Anesthesiology CurrentSince Jul 3, 2023 Accepting new patients

Locations

55 E Golf Course Rd
Logan, UT 84321
Phone (435) 760-3734

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1821658014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 465 N STE 604",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843328006",
            "telephone_number": "435-753-1600",
            "fax_number": "435-753-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSLEY",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "13166124-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821658014",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, UT

Sources for this page

Verify at the official NPI Registry.