Individual provider Active NPI

Heidi Kristine Tedrick, OD

  • Optometrist
  • Dover, DE
National Provider Identifier
1104496538
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
I3-0011441 Issued in DE
Practice address
655 S Bay Rd
Dover, DE 19901-4615
Phone
(302) 994-2511
Fax
(302) 633-5385
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X I3-0011441 DE Primary

Addresses

Primary practice location

655 S Bay Rd
Dover, DE 19901-4615

Mailing address

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511

Other practice location 1

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511

Other names 1

  • Heidi Kristine Nelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220131001649 DE Practitioner - Optometry 8628461464 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003785PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Ophthalmology Consultants PA Optometrist CurrentSince Nov 7, 2022 Accepting new patients
Delaware Ophthalmology Consultants PA Optometrist CurrentSince Nov 7, 2022 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist Current Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 15, 2022 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 15, 2022 Accepting new patients

Locations

885 S Governors Ave
Dover, DE 19904
Phone (302) 734-5861

272 Carter Dr
Ste 100
Middletown, DE 19709
Phone (302) 477-2626

1941 Limestone Rd
Ste 205
Wilmington, DE 19808
Phone (302) 479-3937

3509 Silverside Rd
Wilmington, DE 19810
Phone (302) 477-2621

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: htedrick@doc1004.srs-direct.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1104496538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-994-2511",
            "fax_number": "302-633-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S BAY RD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014615",
            "telephone_number": "302-994-2511",
            "fax_number": "302-633-5385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Kirkwood Hwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198054917",
            "country_code": "US",
            "telephone_number": "302-994-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDRICK",
        "first_name": "HEIDI",
        "middle_name": "KRISTINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0011441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "NELSON",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.