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

Individual provider Physician Assistant · NPI 1669956249

Tyler Jay Denmeade, PA-C is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2018, 8 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
8
Licensed in
GA
In the registry since
2018
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

600 Professional Dr Ste 120
Lawrenceville, GA 30046-7638
Phone: (770) 740-1860
Fax: (678) 347-2104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 008969 (GA)

Record details

NPI number1669956249
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 20, 2018
Last updated in NPPESSeptember 20, 2018
Mailing address925 N Point Pkwy Ste 130, Alpharetta, GA 30005-5211

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lawrenceville