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TIYA SHALYSE JOHNSON M.D.
NPI 1154696359
Psychiatry & Neurology - Child & Adolescent Psychiatry in Tyler, TX

Active since March 20, 2012PECOS Enrolled
11937 US HIGHWAY 271, TYLER, TX 75708(903) 877-7168(903) 877-8355 Get Directions Write a Review

NPPES record last updated: August 17, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 17, 2020, Jun 14, 2018 (2 updates tracked since 2018).

About Tiya Shalyse Johnson M.d. NPPES

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

TIYA SHALYSE JOHNSON M.D. (NPI 1154696359) is an individual child & adolescent psychiatry provider in Tyler, Texas, licensed in Texas (S7462) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1154696359
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameTIYA SHALYSE JOHNSONCredential: M.D.
Location Address11937 US HIGHWAY 271Tyler, TX 75708-3154
Mailing Address11937 Us Highway 271Tyler, TX 75708-3154 · (903) 877-7168 · Fax (903) 877-8355
Phone(903) 877-7168
Fax(903) 877-8355
Sole ProprietorNo
Enumeration DateMarch 20, 2012
Last NPPES UpdateAugust 17, 20202 updates tracked since enumeration
NPPES CertifiedAugust 17, 2020
✔ NPI 1154696359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Licenses✔ Licensed in TX · S7462✔ Licensed in KY · 48143✔ Licensed in FL · ME129560✔ Licensed in OH · 130324
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · Forensic PsychiatryTaxonomy 2084F0202X · License 48143 (KY), 130324 (OH), ME129560 (FL)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 130324 (OH), ME129560 (FL), 48143 (KY)
11937 US HIGHWAY 271, Tyler, TX 75708
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1200 E Chestnut St, 2nd FloorLouisville, KY 40202-1831 · Phone (502) 588-0809
Location 2100 Executive Park # 103Louisville, KY 40207 · Phone (502) 313-6877

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiya Shalyse Johnson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

4

Medicare enrollment records show Tiya Johnson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Texas Health Science Center At Tyler-Facility-Physician
Same address
Neuromusculoskeletal Medicine, Sports Medicine
11937 US HIGHWAY 271
Tyler, TX 75708
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: University Of Texas Health Science Center At Tyler-Facilty-Physician
  • 299 clinicians in this Medicare group
NPI 1063400778 (903) 877-3451
Andrews Center/ Phillips
7.8 mi
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
210 W PHILLIPS ST
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Andrews Center
  • 71 clinicians in this Medicare group
NPI 1063436665 (903) 593-8861
New Leaf Clinic
666 mi
Adult Mental Health
2910 W JEFFERSON ST
Louisville, KY 40212
  • Reassigned Medicare billing, Kentucky enrollment
  • 7 clinicians in this Medicare group
NPI 1659884872 (502) 435-8321
Psychological & Behavioral Consultants, LLC
980 mi
Psychiatry
25101 CHAGRIN BLVD STE 100
Beachwood, OH 44122
  • Reassigned Medicare billing, Kentucky enrollment
  • 198 clinicians in this Medicare group
NPI 1811915713 (216) 468-5000

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 20

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

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER
Psychiatric Unit
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
TYLER DAVIS DO
Surgery (Trauma Surgery)
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7777
PATRICIA DIANNE SHACKELFORD
Pharmacist
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7088
JENNIFER ANNISA MATHEW DO
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
JASMINE MARIE GAMBOA MD
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
DR. SADIE ROSE WALTER DO
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
RENDALL NORTHCUTT FNP
Nurse Practitioner (Primary Care)
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
ES-HAQ SADDELDIN HASSANIN DO
Hospitalist
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7253

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 Tiya Johnson's NPI number?

The NPI number for Tiya Johnson is 1154696359. It was assigned to this individual provider in the NPPES registry on March 20, 2012.

Where is Tiya Johnson located?

Tiya Johnson practices at 11937 Us Highway 271, Tyler, TX 75708. The listed phone number is (903) 877-7168.

What is Tiya Johnson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Tiya Johnson enrolled in Medicare?

Yes. Tiya Johnson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tiya Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tiya Johnson reassigns Medicare benefits to 4 organizations: University Of Texas Health Science Center At Tyler-Facility-Physician (Tyler, TX), Andrews Center/ Phillips (Tyler, TX), New Leaf Clinic (Louisville, KY) and Psychological & Behavioral Consultants, LLC (Beachwood, OH). Each 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 Tiya Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tiya Johnson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Tiya Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tiya Johnson was last updated on August 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.