Tyler Kitzman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3407 Issued in TN

Practice address

1225 Madison Ave
Memphis, TN 38104-2211

Phone

(901) 722-3250

NPI assigned

Jul 19, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, TN2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1851384986
  Medicare reassignment Care Compare group NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164875787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Tahlequah",
            "state": "OK",
            "postal_code": "744647017",
            "country_code": "US",
            "telephone_number": "918-458-2108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITZMAN",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2891",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Aryah Kitabchi, APN
• Kristin Wilson Kitchen, SOCIAL WORKER MSSW
• Rolanda Kitchen
• Michelle Dawn Kitson, MD
• Halie Cottrill Kitzman, O.D.
• Michelle Sharon Klausner
• Jeffery M Klco, M.D.
• Rebekah Lynn Kleck, CRNA
• Laura Kleiman, OT
• Victor J. Kleinaitis, D.D.S.

• Optometrist in Memphis, TN
• Providers in Memphis, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.