Individual provider Active NPI

Tyler Leigh Wilson, DNP AGNP

  • Adult Health Nurse Practitioner
  • Gansevoort, NY
National Provider Identifier
1851028682
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310983 Issued in NY
Practice address
1299 Route 9
Gansevoort, NY 12831-1560
Phone
(518) 761-6961
Fax
(518) 761-1006
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 310983 NY Primary

Addresses

Primary practice location

1299 Route 9
Gansevoort, NY 12831-1560

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

3767 Main Street
Warrensburg, NY 12885-1890
Phone (518) 623-2844

Other practice location 2

100 Broad St
Glens Falls, NY 12801-4349
Phone (518) 792-2223

Other identifiers 1

IdentifierTypeStateIssuer
07478788MedicaidNY

Other names 1

  • Tyler Launhardt Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address tyler.wilson.1@1823.direct.athenahealth.com
Direct Messaging Address tyler.wilson.1@1823.direct.athenahealth.com
Direct Messaging Address tyler.wilson.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130001431 NY Practitioner - Nurse Practitioner 6002284759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

Hospital & facility affiliations

  • Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
310983NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network CurrentSince Nov 7, 2022 Accepting new patients
Hudson Headwaters Health Network CurrentSince Nov 7, 2022 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

1299 Route 9
Gansevoort, NY 12831
Phone (518) 761-6961

100 Broad St
Glens Falls, NY 12801
Phone (518) 792-2223

161 Carey Rd
Queensbury, NY 12804
Phone (518) 480-0011

9 Carey Rd
Queensbury, NY 12804

3767 Main St
Warrensburg, NY 12885
Phone (518) 623-2844

Organizations & group practices 3

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 7

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": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1851028682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 ROUTE 9",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128311560",
            "telephone_number": "518-761-6961",
            "fax_number": "518-761-1006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Main Street",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "NY",
            "postal_code": "128851890",
            "country_code": "US",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Broad St",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "128014349",
            "country_code": "US",
            "telephone_number": "518-792-2223",
            "fax_number": "518-792-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TYLER",
        "middle_name": "LEIGH",
        "credential": "DNP AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07478788",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.wilson.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1299 Route 9",
            "city": "Gansevoort",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128311560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.wilson.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Broad St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.wilson.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3767 Main Street",
            "city": "Warrensburg",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128851890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "LAUNHARDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gansevoort, NY

Sources for this page

Verify at the official NPI Registry.