Individual provider Active NPI

Tyler Darl Albrecht, D.C.

  • Chiropractor
  • St Augustine, FL
National Provider Identifier
1982937173
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9751 Issued in FL
Practice address
1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719
Phone
(904) 429-7750
Fax
(904) 429-7664
NPI assigned
Sep 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9751 FL Primary

Addresses

Primary practice location

1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719

Mailing address

1750 Tree Blvd Ste 8
St Augustine, FL 32084-5719
Phone (904) 429-7750

Other identifiers 1

IdentifierTypeStateIssuer
2209NOtherFLBLUE CROSS BLUE SHIELD OF FLORIDA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000048 FL Practitioner - Chiropractic 9638341381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1750 Tree Blvd
Suite 8
Saint Augustine, FL 32084-5719
Phone (904) 429-7750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9751FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Darl Albrecht D.C., P.a. Chiropractor CurrentSince Aug 8, 2011 Accepting new patients

Locations

1750 Tree Blvd
Ste 8
St Augustine, FL 32084
Phone (904) 429-7750

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.

NPI Registry JSON

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1982937173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 8",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-429-7750",
            "fax_number": "904-429-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 8",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-429-7750",
            "fax_number": "904-429-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBRECHT",
        "first_name": "TYLER",
        "middle_name": "DARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-07",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "2209N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.