Tyler William Randall, in Canon City, CO - Medicare Nurse Practitioner

Tyler William Randall, is a medicare enrolled "Nurse Practitioner - Family" in Canon City, Colorado. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice South Sound Inpatient Physicians Pllc, Dlp Frye Hospitalists Llc and his current practice location is 1338 Phay Ave, Canon City, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 285-2000.

Tyler William Randall is licensed to practice in Colorado (license number APN.0994692-NP) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780241794.

Contact Information

	Tyler William Randall,
	1338 Phay Ave, Canon City, CO 81212-2311
	(719) 285-2000
	Not Available

Map and Direction

Provider's Profile

Full Name	Tyler William Randall
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	1338 Phay Ave, Canon City, Colorado
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tyler William Randall graduated from nursing school in 2019

NPI Data:

NPI Number: 1780241794
Provider Enumeration Date: 05/24/2019
Last Update Date: 06/19/2024

Medicare PECOS Information:

PECOS PAC ID: 8921337544
Enrollment ID: I20210928003853

Medical Identifiers

Medical identifiers for Tyler William Randall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780241794	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	AP61177225 (Washington)	Secondary
363LF0000X	Nurse Practitioner - Family	AP61177225 (Washington)	Secondary
363LF0000X	Nurse Practitioner - Family	APN.0994692-NP (Colorado)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St Joseph Hospital	Bellingham, WA	Hospital
Frye Regional Medical Center	Hickory, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
South Sound Inpatient Physicians Pllc	5991618738	302
Dlp Frye Hospitalists Llc	1951702539	25

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tyler William Randall allows following entities to bill medicare on his behalf.

Entity Name	South Sound Inpatient Physicians Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023285756 PECOS PAC ID: 5991618738 Enrollment ID: O20031107000668

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler William Randall is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Tyler William Randall, Po Box 911057, Denver, CO 80291-1057 Ph: (800) 953-0104	Tyler William Randall, 1338 Phay Ave, Canon City, CO 81212-2311 Ph: (719) 285-2000

Reviews and Comments

Nurse Practitioner Nurses in Canon City, CO

Mr. Karl James Weber, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 129 Savage Loop, Canon City, CO 81212 Phone: 720-467-9478
Mrs. Deborah Eileen Shock, ANP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 275 W Hwy 50, Canon City, CO 81212 Phone: 719-269-4078
Marsha L. Coberly, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, St Thomas More Hospital, Canon City, CO 81212 Phone: 719-285-2000
Teresa A. Hoskins, Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3225 Independence Rd, Canon City, CO 81212 Phone: 719-275-2351
Ms. Betty Ann Krenson, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 602 Yale Pl, Canon City, CO 81212 Phone: 719-275-2301 Fax: 719-275-7048
Sarah Troemel, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 715 S 9th St, Canon City, CO 81212 Phone: 719-269-8820
Mrs. Susan Katherine Frady, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 715 S 9th St, Canon City, CO 81212 Phone: 719-269-8820 Fax: 719-204-0230

Tyler William Randall, - Medicare Nurse Practitioner in Canon City, CO