TYLER ROBERTS (MSN, APRN, FNP-C) – Family Nurse Practitioner, NPI 1104588599

TYLER ROBERTS (MSN, APRN, FNP-C) is a healthcare provider. based in Lubbock, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, APRN, FNP-C. They hold a License No. 1105863 (TX). The NPI Number for TYLER ROBERTS (MSN, APRN, FNP-C) is 1104588599

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
TYLER ROBERTS (MSN, APRN, FNP-C)
NPI
1104588599
Phone
(806) 792-4329
Address
4110 22ND PL
Enumeration Date
12 October 2021
Last Update Date
24 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8097924329
Graduation Year
2022 (4 years ago)
PAC ID
5496114662
Group Practice PAC ID
2466404447
Professional Enrollment ID
I20230706001395
Address ID
TX794101122LU4110XPLXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for TYLER ROBERTS (MSN, APRN, FNP-C)

  • 4110 22ND PL

    LUBBOCK, TX 794101122

    Phone: (806) 792-4329

    Type: Mailing

  • 10125 VIRGINIA AVE

    LUBBOCK, TX 794244659

    Phone: (806) 544-5909

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $618.

Total Amount is formed as General ($618) + Research ($0) + Ownership ($0) = $618.

Last reported payment date: 2024-10-16 • Largest payer in this snapshot: Phathom Pharmaceuticals, Inc. ($123).

Total Amount

$618

General + Research + Ownership

Payments

11

Total payment records

General Amount

$618

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-16

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-07-06

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
I20230706001395INurse PractitionerTXTBD

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 79410)

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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: 2466404447View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Nurse PractitionerTX
Physical Therapist In Private PracticeTX
Orthopedic SurgeryTX
-TX
Physical Therapist In Private PracticeTX
Orthopedic Surgery, Sports MedicineTX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What NPI should I save for TYLER ROBERTS (MSN, APRN, FNP-C)?
Save NPI 1104588599 if you need a stable reference for TYLER ROBERTS (MSN, APRN, FNP-C).
Is TYLER ROBERTS (MSN, APRN, FNP-C) active in the national directory?
TYLER ROBERTS (MSN, APRN, FNP-C)'s public NPI profile is in an active state.
What field does TYLER ROBERTS (MSN, APRN, FNP-C) work in?
You can think of TYLER ROBERTS (MSN, APRN, FNP-C) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is TYLER ROBERTS (MSN, APRN, FNP-C)'s primary listing?
We display Lubbock, Texas because that is what the record indicates for TYLER ROBERTS (MSN, APRN, FNP-C).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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