Jeffrey Reed Tidswell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1184 Issued in CO

Practice address

1625 E Platte Ave
Colorado Springs, CO 80909-5620

Phone

(719) 632-3561

Fax

(719) 633-0284

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Colorado PCGroup PAC ID 7113359415, 58 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Myeyedr Optometry of Colorado PC

  dba MyEyeDr.

  • Optometrist
  • Parker, CO
  • NPI 1174170526
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Colorado PC

  • Optometrist
  • Parker, CO
  • NPI 1164382842
  NPD
• Myeyedr Optometry of Colorado PC

  dba MyEyeDr.

  • Optometrist
  • Centennial, CO
  • NPI 1427666551
  NPD
• Kiowa County Public Health Agency

  • Public Health or Welfare Agency
  • Eads, CO
  • NPI 1114180486
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1245221704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "719-633-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E PLATTE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095620",
            "telephone_number": "719-632-3561",
            "fax_number": "719-633-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDSWELL",
        "first_name": "JEFFREY",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08011843",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Kathryn Thye, PTA
• Tibbie Rae's Transportation LLC
• Kimberly R Tibbs, MD
• Catherine Tickle, HAD
• Tidswell Eyecare, Inc.
• Joshua Andrew Tidwell, LPC, NCC
• Amber Tiedeman, PTA, CSCS
• Prince M Tieku, PHARMD
• Gregory Carl Tietz
• Tiffany's Specialized Care

• Optometrist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.