Tyler John Longstreet, - Medicare Physician Assistant in Wilkes Barre, PA

Tyler John Longstreet, is a medicare enrolled "Physician Assistant" in Wilkes Barre, Pennsylvania. His current practice location is 25 Church St, Wilkes Barre, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (570) 808-3100.

Tyler John Longstreet is licensed to practice in Pennsylvania (license number MA059462) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124539044.

Contact Information

Tyler John Longstreet,
25 Church St,
Wilkes Barre, PA 18702-3507
(570) 808-3100
(570) 808-2539



Provider's Profile

Full NameTyler John Longstreet
GenderMale
SpecialityPhysician Assistant
Location25 Church St, Wilkes Barre, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124539044
  • Provider Enumeration Date: 10/18/2017
  • Last Update Date: 05/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7416219340
  • Enrollment ID: I20180313000722

Medical Identifiers

Medical identifiers for Tyler John Longstreet such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124539044NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical MA059462 (Pennsylvania)Secondary
363A00000XPhysician Assistant MA059462 (Pennsylvania)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler John Longstreet is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tyler John Longstreet,
100 N Academy Ave,
Danville, PA 17822-4903

Ph: (570) 271-6144
Tyler John Longstreet,
25 Church St,
Wilkes Barre, PA 18702-3507

Ph: (570) 808-3100

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Physician Assistant Nurses in Wilkes Barre, PA

Nicholas Charles James, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1111 E End Blvd, Wilkes Barre, PA 18711
Phone: 570-824-3451    
Mrs. Channing Elizabeth Boback, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 675 Baltimore Dr, Wilkes Barre, PA 18702
Phone: 570-808-1000    Fax: 570-808-7698
Mr. Douglas W. Long, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711
Phone: 570-820-6020    Fax: 570-821-2306
Miss Erin Corrine Neuner, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1000 E. Mountain Blvd, Wilkes Barre, PA 18711
Phone: 570-808-7861    
Ms. April Dawn Gonzales,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1000 E Mountain Dr, Wilkes Barre, PA 18711
Phone: 570-808-7399    Fax: 570-808-5942
Rachel M. Yenkowski, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1155 E Mountain Blvd, Wilkes Barre, PA 18702
Phone: 570-808-5135    Fax: 570-808-5136
Alexis Membrino, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 169 N Pennsylvania Ave, Wilkes Barre, PA 18701
Phone: 570-491-0126    Fax: 570-230-0013

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