Tyler Rodericks, DPM is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Largo, Florida. His current practice location is
12416 66th St Ste A, Largo, Florida. You can reach out to his office (for appointments etc.) via phone at
(727) 547-4700.
Tyler Rodericks is licensed to practice in Florida (license number PO4481) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760045447.
Healthcare Provider's Profile
| Full Name | Tyler Rodericks |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 12416 66th St Ste A, Largo, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760045447
- Provider Enumeration Date: 04/17/2019
- Last Update Date: 06/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 0941667646
- Enrollment ID: I20230612002991
Medical Identifiers
Medical identifiers for Tyler Rodericks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760045447 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | PDL1528 (Massachusetts) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | PO4481 (Florida) | Primary |
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 Rodericks allows following entities to bill medicare on his behalf.
| Provider Name | Alexander Medical Group Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1265453286
PECOS PAC ID: 0547299836
Enrollment ID: O20050808000162 |
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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 Rodericks 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 |
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Tyler Rodericks, DPM
27 Ashland St,
Watertown, MA 02472-2920
Ph: (408) 693-1999 | Tyler Rodericks, DPM
12416 66th St Ste A,
Largo, FL 33773-3430
Ph: (727) 547-4700 |
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