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DR. TYLER D PETERSON DMD
NPI 1316733082
Student in an Organized Health Care Education/Training Program in Farmington, CT

Active since April 17, 2025PECOS Enrolled
263 FARMINGTON AVE, FARMINGTON, CT 06030(860) 679-2000 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Tyler D Peterson Dmd NPPES

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

DR. TYLER D PETERSON DMD (NPI 1316733082) is an individual student in an organized health care education/training program in Farmington, Connecticut, licensed in Connecticut (14388) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316733082
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. TYLER D PETERSONCredential: DMD
Location Address263 FARMINGTON AVEFarmington, CT 06030-0001
Mailing Address100 Ryefield Village Dr Unit 163Bloomfield, CT 06002-1660 · (480) 276-5727
Phone(860) 679-2000
Sole ProprietorNo
Enumeration DateApril 17, 2025
Last NPPES UpdateJune 6, 2025
NPPES CertifiedJune 6, 2025
✔ NPI 1316733082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CT · 14388
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.

263 FARMINGTON AVE, Farmington, CT 06030
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tyler D Peterson Dmd 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.

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.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

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 Peterson's NPI number?

The NPI number for Tyler Peterson is 1316733082. It was assigned to this individual provider in the NPPES registry on April 17, 2025.

Where is Tyler Peterson located?

Tyler Peterson practices at 263 Farmington Ave, Farmington, CT 06030. The listed phone number is (860) 679-2000.

What is Tyler Peterson'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 Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tyler Peterson was last updated on June 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.