Individual provider Active NPI

Tiffany Lee Kruger, D.O.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Crestview, FL
National Provider Identifier
1295981066
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
OS10815 Issued in FL
Practice address
100 Price-Gregory Way
Crestview, FL 32536-5305
Phone
(850) 683-3937
Fax
(850) 683-0227
NPI assigned
Aug 13, 2008
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X OS10815 FL
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X OS10815 FL Primary

Addresses

Primary practice location

100 Price-Gregory Way
Crestview, FL 32536-5305

Mailing address

100 Price-Gregory Way
Crestview, FL 32536-5305
Phone (850) 683-3937

Other names 1

  • Tiffany Lee Gomillion Former name

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130926000101 FL Practitioner - Ophthalmology 0648414961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okaloosa Ophthalmology Pediatric and Adult Eye CareGroup PAC ID 6507154861, 2 clinicians

Practice addresses (Care Compare)

4100 S Ferdon Blvd
Suite C2
Crestview, FL 32536-5287
Phone (850) 683-3937

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS10815FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gayla Rowland, M.D., PLLC Ophthalmology CurrentSince May 19, 2024 Accepting new patients
North Okaloosa Clinic Corp CurrentSince Sep 1, 2013 Accepting new patients
North Okaloosa Clinic Corp CurrentSince Sep 1, 2013 Accepting new patients
Okaloosa Ophthalmology Pediatric & Adult Eye Care Ophthalmology CurrentSince May 29, 2016 Accepting new patients
Okaloosa Ophthalmology Pediatric & Adult Eye Care Ophthalmology PastSince May 29, 2016 Accepting new patients

Locations

1299 Industrial Dr
Ste 200
Crestview, FL 32539
Phone (850) 683-3937

4100 S Ferdon Blvd
Ste C2
Crestview, FL 32536
Phone (850) 423-4603

550 Redstone Ave W
Ste 470
Crestview, FL 32536
Phone (850) 689-2223

1507 Merchants Way
Ste A
Niceville, FL 32578
Phone (850) 897-3600

330 Franklin Rd
Ste 135A
Brentwood, TN 37027
Phone (615) 431-5484

Interoperability endpoints

  • Direct secure messaging: krugert@yourcarecommunity.org

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1295981066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PRICE-GREGORY WAY",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365305",
            "telephone_number": "850-683-3937",
            "fax_number": "850-683-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRICE-GREGORY WAY",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365305",
            "telephone_number": "850-683-3937",
            "fax_number": "850-683-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "TIFFANY",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS10815",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "FL",
            "license": "OS10815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "GOMILLION",
            "middle_name": "LEE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.