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

Tyler R Tanzyus, FNP-BC

Individual provider Nurse Practitioner · NPI 1245856657

Tyler R Tanzyus, FNP-BC is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2021, 5 years ago. Practices with Physician Groups Lc, a 524-clinician group and accepts Medicare assignment. Licensed in Illinois and Missouri.

Years since qualifying
5
Licensed in
IL, MO
In the registry since
2020
Specialties on file
4
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

3009 N Ballas Rd Ste 102B
Saint Louis, MO 63131-2343
Phone: (314) 996-7080
Fax: (314) 996-7085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2023047204 (MO)
Nurse Practitioner Taxonomy 363L00000X · Licence 209023840 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209023840 (IL)

Record details

NPI number1245856657
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJune 22, 2020
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Physician Groups Lc — 524 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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