Tyler J. Mortellaro, D.O.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

Phone

(330) 971-7225

NPI assigned

Apr 18, 2023

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 OH

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)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1972290385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 LIVE OAK RD",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801048548",
            "telephone_number": "732-814-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-971-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTELLARO",
        "first_name": "TYLER",
        "middle_name": "J.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Anne Morgan, MSN, CRNP
• Lance D Morgan Jr.
• Kayla Lyn Morris, COTA/L
• Tonia Morris
• Lee A. Morrow, D.D.S.
• Rachel Mosko
• Paris Lavon Motley
• Joel Mowrey, PH.D.
• Omar Fawzi Mujahed, DO
• Anthony Michael Munafo, M.A. CCC-SLP

• Student in an Organized Health Care Education/Training Program in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.