Tyler Maxon Optometrist PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TYLER MAXON OPTOMETRIST PLLC

Practice address

228 E Seneca St
Manlius, NY 13104-1818

Phone

(760) 819-1141

NPI assigned

Aug 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Tyler Joseph Maxon, O.D.NPI 1053793034

Title

Optometrist

Phone

(760) 819-1141

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler Maxon, O.D.

  • Optometrist
  • Manlius, NY
  • NPI 1053793034
  NPD Authorized official

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

{
    "created_epoch": "1596931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596931200000",
    "number": "1740890227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E SENECA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041818",
            "telephone_number": "760-819-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E SENECA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041818",
            "telephone_number": "760-819-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER MAXON OPTOMETRIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-09",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A",
        "authorized_official_last_name": "MAXON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "760-819-1141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Thornton, LMSW
• Janet Elaine Toffolo, RN
• Robyn Tomlin, LCSW
• Kathryn Ellen Touchette, LPN
• Nicholas Trinkle, RD
• Heidi Elizabeth Urciuoli
• Shawna M Valenta, PHARM D
• Kristen Joy Vieau, AUD
• Vihaan Behavioral Health & Forensic Services
• Village of Manlius

• Optometrist in Manlius, NY
• Providers in Manlius, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.