Tiffany Lee Kruger, D.O.

Primary specialty

Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X

License

OS10815 Issued in FL

Practice address

4100 S Ferdon Blvd Ste C2
Crestview, FL 32536-5287

Phone

(850) 683-3937

Fax

(850) 683-0227

NPI assigned

Aug 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tiffany Lee Gomillion Former name

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

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)

Hospital & facility affiliations

• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krugert@yourcarecommunity.org

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.

• Okaloosa Ophthalmology Pediatric & Adult Eye Care

  • Ophthalmology Physician
  • Crestview, FL
  • NPI 1831543362
  Medicare reassignment Care Compare group NPD Authorized official
• North Okaloosa Clinic Corp

  • Internal Medicine Physician
  • Crestview, FL
  • NPI 1659329852
  Medicare reassignment NPD
• Okaloosa Ophthalmology Pediatric & Adult Eye Care

  • Ophthalmology Physician
  • Crestview, FL
  • NPI 1841119450
  NPD (past) Authorized official
• Gayla Rowland, M.D., PLLC

  • Ophthalmology Physician
  • Crestview, FL
  • NPI 1174372643
  NPD
• North Okaloosa Clinic Corp

  • Durable Medical Equipment & Medical Supplies
  • Crestview, FL
  • NPI 1477738896
  NPD

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

• Crestview Hospital Company, LLC

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1295981066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 S FERDON BLVD STE C2",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365287",
            "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": "4100 S FERDON BLVD STE C2",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365287",
            "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": "2020-04-20",
        "certification_date": "2020-04-20",
        "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"
        }
    ]
}

• Joshua Kaleb Kolmetz, M.D.
• Michelle Koralewski, APRN, FNP-BC
• April Koski, RBT
• Michelle Therese Koski, ARNP
• Marcene Faye Kreifels, M.D.
• Ashlee Lafollette
• Alivia Laird
• Sunday Nesbit Laird, PA-C
• Claire Marie Lakes, FNP-C
• Sarah Leigh Lalic, OTRL

• Pediatric Ophthalmology and Strabismus Specialist Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Pediatric Ophthalmology and Strabismus Specialist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.