Individual provider Active NPI

Tyler Justin Lebel, OD

  • Optometrist
  • Dallas, GA
National Provider Identifier
1285463968
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003587 Issued in GA
Practice address
80 Seven Hills Blvd BLDG 200
Dallas, GA 30132-0544
Phone
(678) 324-4211
NPI assigned
Jul 30, 2024
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003587 GA Primary

Addresses

Primary practice location

80 Seven Hills Blvd BLDG 200
Dallas, GA 30132-0544

Mailing address

80 Seven Hills Blvd BLDG 200
Dallas, GA 30132-0544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241016004184 GA Practitioner - Optometry 6406388305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Huffman Family Eye Care PCGroup PAC ID 3577625169, 3 clinicians

Practice addresses (Care Compare)

80 Seven Hills Blvd
BLDG 200
Dallas, GA 30132-0544
Phone (678) 324-4211

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003587GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Huffman Family Eye Care PC Optometrist CurrentSince Aug 8, 2024 Accepting new patients

Locations

80 Seven Hills Blvd
Bldg 200
Dallas, GA 30132
Phone (678) 324-4211

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1285463968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEVEN HILLS BLVD BLDG 200",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEVEN HILLS BLVD BLDG 200",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320544",
            "telephone_number": "678-324-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEL",
        "first_name": "TYLER",
        "middle_name": "JUSTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.