Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tyler Brueckman, PA-C

Individual provider Physician Assistant · NPI 1417780545

Tyler Brueckman, PA-C is a Physician Assistant in Dayton, Ohio. Qualified in 2024, 2 years ago. Practices with Beacon Orthopaedics and Sports Medicine Ltd, a 471-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
2
Licensed in
OH
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3205 Woodman Dr
Dayton, OH 45420-1143
Phone: (937) 298-4417
Fax: (937) 298-8260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 70 Weller Dr, Tipp City, OH 45371-3306 — (937) 669-0909
  • 2066 W Main St Ste 130, Xenia, OH 45385-2882 — (937) 372-7583

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50-008947 (OH)

Record details

NPI number1417780545
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 23, 2024
Last updated in NPPESOctober 13, 2025
Certification dateOctober 13, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Beacon Orthopaedics And Sports Medicine Ltd — 471 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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