NPIMap

Individual provider Active NPI

Tyler Robert Tefft, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1962044321
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3409 Issued in SC
Practice address
905 Verdae Blvd Ste 101
Greenville, SC 29607-4098
Phone
(864) 990-1910
Fax
(864) 990-1911
NPI assigned
Oct 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3409 SC Primary

Addresses

Primary practice location

905 Verdae Blvd Ste 101
Greenville, SC 29607-4098

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311001494 SC Practitioner - Physician Assistant 1759719446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Urgent Care of South Carolina PCGroup PAC ID 1254703788, 158 clinicians

Practice addresses (Care Compare)

122 S Main St
Mauldin, SC 29662-2554
Phone (864) 284-4420

1298 Woodruff Rd
FL 4
Greenville, SC 29607-5754
Phone (864) 236-4700

1305 S Suber Rd
Greer, SC 29650-0944
Phone (864) 989-4609

1515 E Main St
Duncan, SC 29334-9218
Phone (843) 984-0773

3025 Wade Hampton Blvd
Taylors, SC 29687-2715
Phone (864) 643-2340

718 Fairview Rd
Simpsonville, SC 29680-7117
Phone (864) 794-6555

Hospital & facility affiliations

  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3409SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jul 9, 2024 Accepting new patients
Cep America LLC CurrentSince Jul 9, 2024 Accepting new patients
Emergency Physician Services Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

3970 Grandview Dr
Simpsonville, SC 29680
Phone (864) 255-1000

Interoperability endpoints

  • Direct secure messaging: ttefft731504@direct.ghs.myhfn.org

Organizations & group practices 6

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 9

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1962044321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 VERDAE BLVD STE 101",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074098",
            "telephone_number": "864-990-1910",
            "fax_number": "864-990-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEFFT",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.