TYSON DARRELL GREENER PA-C
NPI 1356123863
Physician Assistant - Surgical in Burley, ID

Q: What is Tyson Greener's NPI number?

The NPI number for Tyson Greener is 1356123863. It was assigned to this individual provider in the NPPES registry on October 18, 2023.

Q: What is Tyson Greener's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Tyson Greener was last updated on February 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since October 18, 2023PECOS EnrolledAccepts Medicare Assignment

260 E 5TH ST N, BURLEY, ID 83318(208) 678-9760(208) 678-9758 Get Directions Write a Review

NPPES record last updated: February 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 7, 2025, Oct 18, 2023 (2 updates tracked since 2023).

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About Tyson Darrell Greener Pa-c NPPES

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

TYSON DARRELL GREENER PA-C (NPI 1356123863) is an individual surgical provider in Burley, Idaho, licensed in Idaho (6571244) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Rupert, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1356123863

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameTYSON DARRELL GREENERCredential: PA-C

Location Address260 E 5TH ST NBurley, ID 83318-3453

Mailing Address684 E 400 NRupert, ID 83350-9460 · (208) 670-7008

Phone(208) 678-9760

Fax(208) 678-9758

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 18, 2023

Last NPPES UpdateFebruary 7, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2025

✔ NPI 1356123863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in ID · 6571244

Also ListedPhysician AssistantTaxonomy 363A00000X

260 E 5TH ST N, Burley, ID 83318

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Secondary Practice Location 1

Location 11224 8th StRupert, ID 83350-1599 · Phone (208) 436-0481 · Fax (208) 436-6038

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Tyson Darrell Greener Pa-c 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 ID1153842828

PECOS Enrollment IDI20250311000762

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 3

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

MEG ESTELLE BOLLINGER FNP-C

Nurse Practitioner (Family)

260 E 5TH ST N
BURLEY, ID 83318

Cassia County (208) 678-9760

DR. GILBERT K CRANE M.D

Orthopaedic Surgery

260 E 5TH ST N
BURLEY, ID 83318

Cassia County (208) 678-9760

DR. DEREK HARPER DPM

Podiatrist (Foot & Ankle Surgery)

260 E 5TH ST N
BURLEY, ID 83318

Cassia County (208) 678-9760

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 Tyson Greener's NPI number?

The NPI number for Tyson Greener is 1356123863. It was assigned to this individual provider in the NPPES registry on October 18, 2023.

Where is Tyson Greener located?

Tyson Greener practices at 260 E 5th St N, Burley, ID 83318. The listed phone number is (208) 678-9760.

What is Tyson Greener's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Tyson Greener enrolled in Medicare?

Yes. Tyson Greener 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.

What insurance does Tyson Greener accept?

Health plans from Providence Health Plan list Tyson Greener 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 Tyson Greener was last updated on February 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.