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DR. TYNAN WYATT M.D.
NPI 1306231840
Family Medicine in San Diego, CA

Active since April 01, 2015PECOS EnrolledAccepts Medicare Assignment
4077 FIFTH AVE # MER35, SAN DIEGO, CA 92103(619) 691-7587 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 12, 2026, Jul 30, 2018 (2 updates tracked since 2018).

About Dr. Tynan Wyatt M.d. NPPES

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

DR. TYNAN WYATT M.D. (NPI 1306231840) is an individual family medicine provider in San Diego, California, licensed in California (A146408) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1306231840
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. TYNAN WYATTCredential: M.D.
Location Address4077 FIFTH AVE # MER35San Diego, CA 92103-2105
Mailing Address4077 Fifth Ave # Mer-35San Diego, CA 92103-2105 · (619) 691-7587
Phone(619) 691-7587
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 1, 2015
Last NPPES UpdateJanuary 12, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2026
✔ NPI 1306231840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A146408
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4077 FIFTH AVE # MER35, San Diego, CA 92103
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Secondary Practice Locations 2

Location 14077 Fifth Ave # Mer35San Diego, CA 92103 · Phone (619) 691-7587
Location 2950 S Euclid AveSan Diego, CA 92114-6201 · Phone (619) 662-4100

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tynan Wyatt M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062773898
PECOS Enrollment IDI20260120002448
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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 20

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

DR. PRANAY RAG BONAGIRI DO
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 260-7220
ANDY M CHAN DO
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 294-8111
MARGARET CULVER MCDERMOTT MD
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 294-8111
KENNETH R STEVENS III
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (503) 998-0614
CODY MITCHELL DELANEY
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 260-7220
JENNA LAVINA
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 260-7220
DR. CHRISTINA MANSOUR MD
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 260-7220
HAO PHUC NGUYEN D.O.
Student in an Organized Health Care Education/Training Program
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
San Diego County (619) 260-7220

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 Tynan Wyatt's NPI number?

The NPI number for Tynan Wyatt is 1306231840. It was assigned to this individual provider in the NPPES registry on April 1, 2015.

Where is Tynan Wyatt located?

Tynan Wyatt practices at 4077 Fifth Ave # Mer35, San Diego, CA 92103. The listed phone number is (619) 691-7587.

What is Tynan Wyatt's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tynan Wyatt enrolled in Medicare?

Yes. Tynan Wyatt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tynan Wyatt was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.