Individual provider Active NPI

Troy K Tyler, DO

  • Vascular Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1982125076
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
OS20586 Issued in FL
Practice address
1824 King St Ste 200
Jacksonville, FL 32204-4736
Phone
(904) 384-3343
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2017018675 MO
Vascular Surgery Physician 2086S0129X OS20586 FL Primary

Addresses

Primary practice location

1824 King St Ste 200
Jacksonville, FL 32204-4736

Mailing address

201 NW R D Mize Rd
Blue Springs, MO 64014-2513

Other practice location 1

201 NW R D Mize Rd
Blue Springs, MO 64014-2513
Phone (816) 655-5361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240419003557 FL Practitioner - Vascular Surgery 3274972443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Alabama College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

2301 N 9TH Ave
Suite 100
Pensacola, FL 32503-3986
Phone (850) 912-8249

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion13
Varicose vein removal26
Leg revascularization (restoring blood flow)28
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017018675MOMDSurgery Physician
OS20586FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic & Vascular Surgical Associates PA Surgery CurrentSince Jun 1, 2024 Accepting new patients

Locations

332 Medcrest Dr
Crestview, FL 32536
Phone (850) 226-7322

1032 Mar Walt Dr
Unit 250
Ft Walton Bch, FL 32547
Phone (850) 682-0032

3575 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 332-6339

1824 King St
Ste 200
Jacksonville, FL 32204
Phone (904) 384-3343

3627 University Blvd S
Ste 135
Jacksonville, FL 32216
Phone (904) 398-8147

1000 Riverside Ave
Ste 200
Jacksonville, FL 32204
Phone (904) 388-7521

6820 Southpoint Pkwy
Ste 1
Jacksonville, FL 32216
Phone (904) 289-9600

8767 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (704) 542-2256

836 Prudential Dr
Ste 1804
Jacksonville, FL 32207
Phone (904) 398-3888

5970 Berryhill Rd
Milton, FL 32570

1677 Eagle Harbor Pkwy
Ste A
Orange Park, FL 32003
Phone (904) 276-2303

1893 Kingsley Ave
Ste A
Orange Park, FL 32073
Phone (904) 272-8080

1851 N 9th Ave
Ste B
Pensacola, FL 32503
Phone (850) 479-4223

5149 N 9th Ave
Ste G20
Pensacola, FL 32504

2301 N 9th Ave
Ste 100
Pensacola, FL 32503
Phone (850) 912-8249

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

5149 N 9th Ave
Ste 120
Pensacola, FL 32504
Phone (850) 426-5191

2130 E Johnson Ave
Ste 120
Pensacola, FL 32514
Phone (850) 332-6339

13000 Sawgrass Village Cir
Ste 32
Ponte Vedra Beach, FL 32082
Phone (904) 394-5347

300 Health Park Blvd
Ste 5008
St Augustine, FL 32086
Phone (904) 494-2394

Organizations & group practices 1

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 3

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1982125076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW R D MIZE RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-384-3343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 NW R D Mize Rd",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640142513",
            "country_code": "US",
            "telephone_number": "816-655-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "TROY",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2017018675",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "OS20586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.