DR. TYLER FISHER MD
NPI 1053057679
Student in an Organized Health Care Education/Training Program in Tucson, AZ

Active since May 06, 2022PECOS Enrolled
10146 E OLD VAIL RD, TUCSON, AZ 85747(520) 574-7400 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 1, 2026, May 6, 2022 (2 updates tracked since 2022).

About Dr. Tyler Fisher Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TYLER FISHER MD (NPI 1053057679) is an individual student in an organized health care education/training program in Tucson, Arizona and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Inverness, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1053057679
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. TYLER FISHERCredential: MD
Location Address10146 E OLD VAIL RDTucson, AZ 85747-9406
Mailing Address502 W Highland BlvdInverness, FL 34452-4720 · (352) 344-6969
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMay 6, 2022
Last NPPES UpdateJune 1, 20262 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
✔ NPI 1053057679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 79134 (AZ)
10146 E OLD VAIL RD, Tucson, AZ 85747

Secondary Practice Location 1

Location 1502 W Highland BlvdInverness, FL 34452-4720 · Phone (352) 344-6969

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tyler Fisher Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022459189
PECOS Enrollment IDI20260629000931
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tyler Fisher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Emergency Medicine
6200 N LA CHOLLA BLVD
Tucson, AZ 85741
  • Reassigned Medicare billing, Arizona enrollment
  • 664 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
10146 E OLD VAIL RD
TUCSON, AZ 85747
Emergency Medicine
10146 E OLD VAIL RD
TUCSON, AZ 85747
Clinic/Center (Emergency Care)
10146 E OLD VAIL RD
TUCSON, AZ 85747
Nurse Practitioner (Family)
10146 E OLD VAIL RD
TUCSON, AZ 85747

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Fisher's NPI number?

The NPI number for Tyler Fisher is 1053057679. It was assigned to this individual provider in the NPPES registry on May 6, 2022.

Where is Tyler Fisher located?

Tyler Fisher practices at 10146 E Old Vail Rd, Tucson, AZ 85747. The listed phone number is (520) 574-7400.

What is Tyler Fisher's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tyler Fisher enrolled in Medicare?

Yes. Tyler Fisher is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tyler Fisher's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Fisher reassigns Medicare benefits to Northwest Hbp Medical Services LLC (Tucson, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tyler Fisher's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tyler Fisher was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.