DR. TYLER GRANTHAM MD
NPI 1841874724
Student in an Organized Health Care Education/Training Program in Staten Island, NY
About Dr. Tyler Grantham Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TYLER GRANTHAM MD (NPI 1841874724) is an individual student in an organized health care education/training program in Staten Island, New York and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Staten Island University Hospital, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Tyler Grantham Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Tyler Grantham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Staten Island University Hospital
Acute Care Hospitals · Staten Island, NYOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STATEN ISLAND, NY 10305
STATEN ISLAND, NY 10305
STATEN ISLAND, NY 10305
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 Grantham's NPI number?
The NPI number for Tyler Grantham is 1841874724. It was assigned to this individual provider in the NPPES registry on May 7, 2021.
Where is Tyler Grantham located?
Tyler Grantham practices at 475 Seaview Ave, Staten Island, NY 10305. The listed phone number is (914) 500-5277.
What is Tyler Grantham'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 Grantham enrolled in Medicare?
Yes. Tyler Grantham 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.
Which organization bills Medicare for Tyler Grantham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Grantham reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The 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 Tyler Grantham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Tyler Grantham affiliated with any hospitals?
According to CMS data, Tyler Grantham is affiliated with Staten Island University Hospital.
When was this NPI record last updated?
The NPPES record for Tyler Grantham was last updated on May 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Tyler Grantham, MD · NPI 1841874724
Student in an Organized Health Care Education/Training Program provider in Staten Island, New York. Individual provider, active in the CMS NPPES registry since May 7, 2021.
## Identity
- **NPI:** 1841874724 (Entity type: Individual)
- **Enumerated:** May 7, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 475 SEAVIEW AVE, Staten Island, NY 10305-3436
- **Phone:** (914) 500-5277
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** North Shore - Lij Medical PC (NPI 1790043479, New Hyde Park, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** May 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1841874724) · Data from the CMS NPPES public registry.