TRACY DAWN TYLER
NPI 1073154365
Nurse Practitioner - Psychiatric/Mental Health in Roswell, GA

Q: What is Tracy Tyler's NPI number?

The NPI number for Tracy Tyler is 1073154365. It was assigned to this individual provider in the NPPES registry on October 8, 2019.

Q: What is Tracy Tyler's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: Is Tracy Tyler enrolled in Medicare?

No. Tracy Tyler has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Tracy Tyler was last updated on October 8, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 08, 2019Opted out of Medicare · through Oct 1, 2027

11111 HOUZE RD STE 225, ROSWELL, GA 30076(770) 603-0123 Get Directions Write a Review

NPPES record last updated: October 8, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Tracy Dawn Tyler NPPES

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

TRACY DAWN TYLER (NPI 1073154365) is an individual psychiatric/mental health provider in Roswell, Georgia, licensed in Georgia (RN239833) and active in the NPI registry since October 2019. She has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1073154365

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameTRACY DAWN TYLER

Location Address11111 HOUZE RD STE 225Roswell, GA 30076-5618

Mailing Address5455 Fieldfreen DrCumming, GA 30028-3898 · (404) 427-4723

Phone(770) 603-0123

Sole ProprietorNo

Enumeration DateOctober 8, 2019

✔ NPI 1073154365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in GA · RN239833

11111 HOUZE RD STE 225, Roswell, GA 30076

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tracy Dawn Tyler has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2023 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2023

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30076 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

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

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