NPIMap

Individual provider Active NPI

Tyler Policht, M.D.

  • Family Medicine Physician
  • Pittston, PA
National Provider Identifier
1982019964
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD471371 Issued in PA
Practice address
42 N Main St
Pittston, PA 18640-1916
Phone
(570) 654-0880
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301105145 MI
Family Medicine Physician 207Q00000X MD471371 PA Primary

Addresses

Primary practice location

42 N Main St
Pittston, PA 18640-1916

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpolicht290148@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180709002000 MI Practitioner - Family Practice 5193027571 Reassigns benefits to 1 organization
I20200917000730 PA Practitioner - Family Practice 5193027571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger Clinic 3,432 clinicians

Practice addresses (Care Compare)

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 283-2161

Hospital & facility affiliations

  • Hospice of the Sacred Heart Hospice, Moosic, PA, CCN 391656
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD471371PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Oct 5, 2020 Accepting new patients
Geisinger Clinic CurrentSince Oct 5, 2020 Accepting new patients
Iha Health Service Corporation CurrentSince May 30, 2018 Accepting new patients
Iha Health Services Corporation CurrentSince May 30, 2018 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

4200 Whitehall Dr
Ste 150
Ann Arbor, MI 48105
Phone (734) 995-0308

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

Interoperability endpoints

  • Direct secure messaging: tpolicht290148@direct.geisinger.edu

Organizations & group practices 12

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1982019964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401916",
            "telephone_number": "570-654-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICHT",
        "first_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301105145",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD471371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpolicht290148@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "42 N Main St",
            "city": "Pittston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186401916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.