Tyler Bague, DPT
NPI 1902778780ActiveIndividual· Physical Therapist· Skaneateles, NY
Physical Therapist (DPT) in Skaneateles, New York, trained at State University of Ny Upstate Medical University (class of 2025). Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1902778780 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Sep 22, 2025 |
| Last updated in NPPES | Sep 22, 2025 |
| Certified by provider | Sep 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 054665-01 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NY) |
|---|
Education and affiliations
| Medical school | State University of Ny Upstate Medical University |
|---|---|
| Graduation year | 2025 |
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Sports Physical Therapy of New York, P.C.Ithaca, NY · 84 clinicians
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All 17 physical therapists in Skaneateles · All physical therapists in New York