Tyler Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 5039 Issued in FL

Practice address

21275 Olean Blvd
Port Charlotte, FL 33952-6704

Phone

(941) 625-1325

NPI assigned

Jul 27, 2014

Last updated

Jul 5, 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, TN2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drroberts@cec.direct.eyemdemr.com

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.

• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1851384986
  Medicare reassignment Care Compare group NPD
• Southern College of Optometry

  dba University Eye Care

  • Optometrist
  • Memphis, TN
  • NPI 1518309202
  NPD (past)

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

{
    "created_epoch": "1406419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1346658945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21275 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "941-625-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21275 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "941-625-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-27",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberto E Puente DPM PLLC (Harbor Foot & Leg Specialists)
• Rosalyn Roberts Gauthier
• Edward Roberts
• Glodene Simone Roberts, ARNP
• Rick Thomas Roberts, PHARMD
• Courtney Robertson, APRN FNP-C
• Randal C Robertson, DMD
• Susan A Rockfield, LMT, LFS, MMP
• Rachel Rodriguez Garcia
• Roxana Maria Rodriguez Rey, APRN

• Optometrist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.