STEPHEN CHARLES TYSON
NPI 1811568140
Anesthesiologist Assistant in Conyers, GA

Q: What is Stephen Tyson's NPI number?

The NPI number for Stephen Tyson is 1811568140. It was assigned to this individual provider in the NPPES registry on July 7, 2021.

Q: What is Stephen Tyson's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Tyson was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 07, 2021Accepts Medicare Assignment

1612 MILSTEAD RD NE STE B, CONYERS, GA 30012(770) 388-7745(770) 922-0526 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Stephen Charles Tyson NPPES

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

STEPHEN CHARLES TYSON (NPI 1811568140) is an individual anesthesiologist assistant in Conyers, Georgia, licensed in Georgia (10610) and active in the NPI registry since July 2021. He is affiliated with Northside Hospital and is a graduate of Other (2021).

NPPES Registry Identity

NPI1811568140

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameSTEPHEN CHARLES TYSON

Location Address1612 MILSTEAD RD NE STE BConyers, GA 30012-3738

Mailing Address4140 Alexis CtLoganville, GA 30052-9070

Phone(770) 388-7745

Fax(770) 922-0526

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 7, 2021

Last NPPES UpdateApril 20, 2023

NPPES CertifiedApril 20, 2023

✔ NPI 1811568140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in GA · 10610

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

1612 MILSTEAD RD NE STE B, Conyers, GA 30012

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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 and accepts Medicare assignment

Stephen Charles Tyson 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 ID4880082106

PECOS Enrollment IDI20211019001704

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

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 Stephen Tyson's NPI number?

The NPI number for Stephen Tyson is 1811568140. It was assigned to this individual provider in the NPPES registry on July 7, 2021.

Where is Stephen Tyson located?

Stephen Tyson practices at 1612 Milstead Rd NE Ste B, Conyers, GA 30012. The listed phone number is (770) 388-7745.

What is Stephen Tyson's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Stephen Tyson enrolled in Medicare?

Yes. Stephen Tyson 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.

Is Stephen Tyson affiliated with any hospitals?

According to CMS data, Stephen Tyson is affiliated with Northside Hospital.

When was this NPI record last updated?

The NPPES record for Stephen Tyson was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.