Tyler M. Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0005701 Issued in CO

Practice address

165 S Union Blvd Ste 800
Lakewood, CO 80228-2213

Phone

(303) 988-2680

Fax

(303) 896-8057

NPI assigned

Feb 7, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare Colorado Medical Group LLCGroup PAC ID 2769706431, 187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tclark121026@westdirect.optum.com

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.

• Optumcare Colorado Medical Group LLC

  • General Practice Physician
  • Colorado Springs, CO
  • NPI 1407252828
  Medicare reassignment Care Compare group NPD (past)
• Long Term Care and Rehab Consultants

  • Family Medicine Physician
  • Arvada, CO
  • NPI 1306946728
  Medicare reassignment
• New West Physicians Inc

  • Internal Medicine Physician
  • Golden, CO
  • NPI 1427010859
  Medicare reassignment
• Optumcare Colorado Medical Group LLC

  • Obstetrics & Gynecology Physician
  • Colorado Springs, CO
  • NPI 1881225175
  NPD
• Optumcare Colorado Medical Group LLC

  • Rheumatology Physician
  • Boulder, CO
  • NPI 1922893478
  NPD
• Optumcare Colorado Medical Group LLC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1528190295
  NPD (past)

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1952866576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S UNION BLVD STE 800",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282213",
            "telephone_number": "303-988-2680",
            "fax_number": "303-896-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TYLER",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-07",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000170986",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kasey Clark, LPCC
• Katelyn E Clark, LAC
• Lindsay Kae Clark
• Mackenzie Clark, LPC
• Madison Clark
• Rohan Courtney Clarke, M.D.
• Yesinia Clary-Washington
• Ty Clase, O.D.
• Taylor Amy Claydon, DPT
• Clear Peak Fertility & Wellness

• Physician Assistant in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.