Tyler James Ridder, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6157 Issued in FL

Practice address

2491 S Ferdon Blvd
Crestview, FL 32536-8463

Phone

(850) 682-4014

Fax

(850) 682-0387

NPI assigned

Jul 26, 2022

Last updated

Jul 26, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas Reynolds OD PAGroup PAC ID 3375584295, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.14 of 100Reported as group

Quality

60.29

Improvement activities

40

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Douglas Reynolds OD PA

  dba Gulf Coast Vision Center

  • Optometrist
  • Pensacola, FL
  • NPI 1023164662
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1275269813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141441",
            "telephone_number": "850-477-1499",
            "fax_number": "850-479-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2491 S FERDON BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325368463",
            "telephone_number": "850-682-4014",
            "fax_number": "850-682-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDER",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Relita Reyes
• Gena Denise Rhodes, M.S., CCC-SLP
• Michele R Richard
• Nikkia Richard
• Christy Dawn Richmond
• Rhonda Renee Riess, M.ED.
• Amy Elizabeth Riggs, O.D.
• Cynthia Jones Riley
• Michael J Rinaldi, D.O.
• Angielice T Rivera de Overstreet, RBT

• Optometrist in Crestview, FL
• Providers in Crestview, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.