Individual provider Active NPI

Tyler Brooks Horton, OD

  • Optometrist
  • Indio, CA
National Provider Identifier
1669114252
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0000 Issued in CA
Practice address
82227 US Highway 111 Ste B2
Indio, CA 92201-5668
Phone
(760) 347-6636
Fax
(844) 833-6644
NPI assigned
Apr 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 0000 CA Primary

Addresses

Primary practice location

82227 US Highway 111 Ste B2
Indio, CA 92201-5668

Mailing address

2801 N Los Felices Cir E
Palm Springs, CA 92262-1499
Phone (805) 903-3518

Other practice location 1

52565 Cesar Chavez St Ste 105
Coachella, CA 92236-1534
Phone (760) 347-6636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220810000793 CA Practitioner - Optometry 8123401031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Brasfield OD a Professional CorporationGroup PAC ID 0749577088, 8 clinicians

Practice addresses (Care Compare)

82227 US Hwy 111
Suite B2
Indio, CA 92201-5668
Phone (760) 347-6636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35151CAMDChiropractor
0000CAMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Brasfield OD a Professional Corporation Optometrist CurrentSince Aug 9, 2022 Accepting new patients
Dr. Gregory L. McFarland, O.D., P.C Optometrist PastSince Apr 9, 2018 Accepting new patients

Locations

34131 Date Palm Dr
Ste F1
Cathedral City, CA 92234

52565 Harrison St
Ste 105
Coachella, CA 92236
Phone (760) 347-6636

82227 US Highway 111
Ste B2
Indio, CA 92201
Phone (760) 347-6636

400 S Farrell Dr
Ste B130
Palm Springs, CA 92262
Phone (760) 347-6636

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1669114252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N LOS FELICES CIR E",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621499",
            "telephone_number": "805-903-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82227 US HIGHWAY 111 STE B2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015668",
            "telephone_number": "760-347-6636",
            "fax_number": "844-833-6644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52565 Cesar Chavez St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Coachella",
            "state": "CA",
            "postal_code": "922361534",
            "country_code": "US",
            "telephone_number": "760-347-6636",
            "fax_number": "844-866-6644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORTON",
        "first_name": "TYLER",
        "middle_name": "BROOKS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.