Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Bague, DPT

Individual provider Physical Therapist · NPI 1902778780

Tyler Bague, DPT is a Physical Therapist in Private Practice in Skaneateles, New York. Graduated from State University of Ny Upstate Medical University in 2025, 1 year ago. Licensed in New York.

Years since qualifying
1
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2025
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

810 W Genesee Street Rd
Skaneateles, NY 13152-9311
Phone: (315) 291-7042
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 054665-01 (NY)

Record details

NPI number1902778780
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 22, 2025
Last updated in NPPESSeptember 22, 2025
Certification dateSeptember 21, 2025
Mailing address2476 W Genesee Tpke Apt 207, Camillus, NY 13031-9524

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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