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

Tyler John Longstreet

Individual provider Medical Physician Assistant · NPI 1124539044

Tyler John Longstreet is a Physician Assistant in Wilkes Barre, Pennsylvania. Qualified in 2017, 9 years ago. Practices with Geisinger Clinic, a 3,413-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
9
Licensed in
PA
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

25 Church St
Wilkes Barre, PA 18702-3507
Phone: (570) 808-3100
Fax: (570) 808-2539
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 — (570) 808-7300

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA059462 (PA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA059462 (PA)

Record details

NPI number1124539044
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 18, 2017
Last updated in NPPESMay 10, 2022
Certification dateMay 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Geisinger Clinic — 3413 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Wilkes Barre