Tyler Green, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

091601 Issued in IA

Practice address

1025 SE Tallgrass Lane Ste 210
Waukee, IA 50263

Phone

(515) 875-9706

Fax

(515) 875-9707

NPI assigned

Sep 1, 2016

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance PT-Blessing Corp Services-Ft Madison Community Hosp

  • Physical Medicine & Rehabilitation Physician
  • Keokuk, IA
  • NPI 1366819021

  Physical Therapist

  Medicare reassignment NPD
• Advance Physical Therapy & Sports Medicine of Adams County LLC

  • Physical Therapist
  • Quincy, IL
  • NPI 1104836105
  Medicare reassignment NPD
• Advance Physical Therapy & Sports Medicine of Chatham LLC

  • Physical Therapist
  • Chatham, IL
  • NPI 1376706234
  Medicare reassignment NPD
• Advance Physical Therapy of Hancock County LLC

  • Physical Therapist
  • Carthage, IL
  • NPI 1831109826
  Medicare reassignment NPD
• Advance Physical Therapy Illini Community Hospital LLC

  • Physical Therapist
  • Pittsfield, IL
  • NPI 1871831388
  Medicare reassignment
• Advance Physical Therapy & Sports Medicine of Adams County LLC

  • Physical Therapy Clinic/Center
  • Quincy, IL
  • NPI 1073882304
  NPD
• Advance Physical Therapy & Sports Medicine of Chatham LLC

  dba Advance Physical Therapy

  • Physical Therapy Clinic/Center
  • Mt Sterling, IL
  • NPI 1619554797
  NPD
• Advance Physical Therapy & Sports Medicine LLC

  • Physical Therapist
  • Quincy, IL
  • NPI 1972513968
  NPD (past)
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1922554658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE TALLGRASS LANE STE 210",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "50263",
            "telephone_number": "515-875-9706",
            "fax_number": "515-875-9707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5950 University Ave Ste 385",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502668216",
            "country_code": "US",
            "telephone_number": "515-875-9706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TYLER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016027260",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "091601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tylergreen@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5950 University Ave Ste 285",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502668236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace Estates LLC
• Graceful Home Care LLC
• Lori Graff
• Kimberly R Grassel, RPT
• Greater Des Moines Orthodontics PLLC
• Emily Joan Greving
• GRX Holdings LLC (Medicap Pharmacy)
• Guardin Transport LLC
• Sapna Sondhi Gupta, D.O.
• Kaitlyn Hall, PT, DPT, ATC

• Physical Therapist in Waukee, IA
• Providers in Waukee, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.