TYLER ZILLMER (M.A.) – Professional Counselor, NPI 1710330691

TYLER ZILLMER (M.A.) is a healthcare provider. based in New brighton, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.A.. They hold a License No. CC01307 (MN). The NPI Number for TYLER ZILLMER (M.A.) is 1710330691

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
TYLER ZILLMER (M.A.)
NPI
1710330691
Phone
(651) 628-9566
Address
1900 SILVER LAKE RD NW
Enumeration Date
15 July 2016
Last Update Date
27 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7637460891
Graduation Year
2013 (13 years ago)
PAC ID
6406206176
Group Practice PAC ID
4789910233
Professional Enrollment ID
I20231220003216
Address ID
MN554343911BL11925NEXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

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Provider Addresses for TYLER ZILLMER (M.A.)

  • 1900, Silver Lake Road Northwest, New Brighton, Ramsey County, Minnesota, 55112, United States

    NEW BRIGHTON, MN 551121786

    Phone: (651) 628-9566

    Fax: (651) 628-0411

    Type: Mailing

  • Coon Rapids Boulevard Northwest, Parkside, Coon Rapids, Anoka County, Minnesota, 55434, United States

    COON RAPIDS, MN 554332643

    Phone: (763) 767-3350

    Fax: (763) 767-0912

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-12-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231220003216IMental Health CounselorMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 55112)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789910233View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Mental Health CounselorHI
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How do payers reference TYLER ZILLMER (M.A.)?
For TYLER ZILLMER (M.A.), use NPI 1710330691 as the unique 10-digit identifier.
Is there an active status for TYLER ZILLMER (M.A.)?
For scheduling context, TYLER ZILLMER (M.A.) is shown as active in the registry.
What area of care is associated with TYLER ZILLMER (M.A.)?
TYLER ZILLMER (M.A.)'s record emphasizes Professional Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for TYLER ZILLMER (M.A.)?
Travel planning: use New Brighton, Minnesota as the reference point for TYLER ZILLMER (M.A.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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