Ty Reso Anderson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS15140 Issued in FL

Practice address

7800 66TH St N Ste 206
Pinellas Park, FL 33781-2101

Phone

(727) 541-0323

Fax

(727) 541-0336

NPI assigned

Jun 16, 2006

Last updated

Nov 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Bayfront Enterprises Inc

  dba Bayfront Convenient Care Clinics

  • Urgent Care Clinic/Center
  • St Petersburg, FL
  • NPI 1710963236
  NPD (past)
• Stanley S Moles & Associates MD's PA

  • Nuclear Radiology Physician
  • Largo, FL
  • NPI 1285616227
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1851335988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 66TH ST N STE 206",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812101",
            "telephone_number": "727-541-0323",
            "fax_number": "727-541-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 66TH ST N STE 206",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812101",
            "telephone_number": "727-541-0323",
            "fax_number": "727-541-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TY",
        "middle_name": "RESO",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anderson Primary Care Associates, PLLC
• Anderson Primary Care PLLC
• Lauren Altman Anderson
• Richard P Anderson, MPT
• Shunteri Anderson
• Laryn Andrews
• Ankle & Foot Center of Tampa Bay
• Awura Afrakumah Appawu
• Michelle Marie Applequist, B.S.
• Hollie H Arad

• Family Medicine Physician in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.