TYLER BLAIR EVANS M.D. NPI 1912227125

NPI Information

NPI: 1912227125
Provider Name: TYLER BLAIR EVANS, M.D.
Classification: Preventive Medicine - 2083P0901X
Entity Type: Individual

Specialization: Public Health & General Preventive Medicine

PECOS Registration: Yes

Address:
250 QUAIL RIDGE RD
SCOTTS VALLEY, CA
ZIP 95066
Phone: (408) 341-9606
Get Directions

Tyler Blair Evans, M.D. is a public health and general preventive medicine preventive medicine in Scotts Valley, CA. The provider is public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. Tyler Blair Evans, M.D. NPI is 1912227125. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

250 QUAIL RIDGE RD
SCOTTS VALLEY, CA
ZIP 95066-821
Phone: (408) 341-9606

The NPI 1912227125 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/10/2010 and was last updated on 2/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		R72287	ARIZONA	No
2	207R00000X	Internal Medicine		262216	NEW YORK	No
3	2083P0901X	Preventive Medicine	Public Health & General Preventive Medicine	262216-1	NEW YORK	No
4	2083P0901X	Preventive Medicine	Public Health & General Preventive Medicine	A148240	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00695941	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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