Tyler Young, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1886 Issued in KS

Legal business name

TYLER YOUNG, O.D., P.A.

Practice address

12129 Shawnee Mission Pkwy
Shawnee, KS 66216

Phone

(913) 808-2020

Fax

(913) 298-2634

NPI assigned

Jan 14, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Tyler Ross Young, ODNPI 1548572811

Title

President/Optometrist

Phone

(913) 808-2020

Specialties & licenses 2

Addresses

Other names 1

• InFocus Family Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Ross Young, O.D.

  • Optometrist
  • Shawnee, KS
  • NPI 1548572811
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1396253191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12129 SHAWNEE MISSION PKWY",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161829",
            "telephone_number": "913-808-2020",
            "fax_number": "913-298-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 SHAWNEE MISSION PKWY",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "66216",
            "telephone_number": "913-808-2020",
            "fax_number": "913-298-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER YOUNG, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-14",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "913-808-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1886",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "KS",
            "license": "1886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InFocus Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Doyle Alan Tweet
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• Candice Underwood, PHARMD
• Stephanie L. Ungashick, CRNA
• Upcare Dental Shawnee LLC
• Aileen Paula Utley, PH.D.

• Optometrist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.