STEPHEN CHARLES TYSON – Anesthesiologist Assistant, NPI 1811568140
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,383 ANESTHESIOLOGY ASSISTANT in GA
Provider Addresses for STEPHEN CHARLES TYSON
4140 ALEXIS CT
LOGANVILLE, GA 300529070
Phone:
Type: Mailing
1612 MILSTEAD RD NE STE B
CONYERS, GA 300123738
Phone: (770) 388-7745
Fax: (770) 922-0526
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $67.
Total Amount is formed as General ($67) + Research ($0) + Ownership ($0) = $67.
Last reported payment date: 2024-06-13 • Largest payer in this snapshot: Medtronic, Inc. ($43).
Total Amount
$67
General + Research + Ownership
Payments
3
Total payment records
General Amount
$67
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $43 |
| Edwards Lifesciences Corporation | $24 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-10-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211019001704 | I | Anesthesiology Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30052)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | FL | |
| Anesthesiology Assistant | FL | |
| Anesthesiology Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Anesthesiology Assistant | GA | |
| Anesthesiology Assistant | GA | |
| Anesthesiology Assistant | GA | |
| A N E S T H E S I O L O G Y | FL | |
| A N E S T H E S I O L O G Y | GA |
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