Individual provider Active NPI

Tyler Robert Hudson, O.D.

  • Optometrist
  • Union, KY
National Provider Identifier
1750518346
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003584A Issued in IN
Practice address
2343 Antoinette Way
Union, KY 41091-7405
Phone
(812) 584-8515
NPI assigned
Jun 22, 2009
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003584A IN Primary
Optometrist 152W00000X 5870 OH
Optometrist 152W00000X 1788DT KY

Addresses

Primary practice location

2343 Antoinette Way
Union, KY 41091-7405

Mailing address

2343 Antoinette Way
Union, KY 41091-7405
Phone (812) 584-8515

Other identifiers 1

IdentifierTypeStateIssuer
3096984MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH, KY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20090922000011 IN Practitioner - Optometry 3971659624 Reassigns benefits to 2 organizations
I20110211000488 OH Practitioner - Optometry 3971659624 Reassigns benefits to 1 organization
I20110622000443 KY Practitioner - Optometry 3971659624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Eye Center, LLCGroup PAC ID 0648421230, 3 clinicians
Lawrenceburg Eye Center, LLCGroup PAC ID 7618309840, 3 clinicians

Practice addresses (Care Compare)

27 N Main St
Walton, KY 41094-1228
Phone (859) 485-3937

403 Walnut St
Suite a
Lawrenceburg, IN 47025-2411
Phone (812) 537-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5870OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC CurrentSince Nov 26, 2012 Accepting new patients
Onhealthcare, LLC Optometrist Current Accepting new patients
Mobile Medical, Inc. CurrentSince Mar 1, 2011 Accepting new patients
Mobile Medical Inc Optometrist CurrentSince Mar 1, 2011 Accepting new patients
Onhealthcare, LLC CurrentSince Nov 26, 2012 Accepting new patients
Lawrenceburg Eye Center, LLC Optometrist CurrentSince Feb 27, 2019 Accepting new patients
Hudson Eye Center, LLC Optometrist CurrentSince Oct 16, 2012 Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
Bluegrass Retina Consultants, PSC PastSince Oct 16, 2012 Accepting new patients
Onhealthcare LLC Past Accepting new patients

Locations

8425 Woodfield Crossing Blvd
Ste 100
Indianapolis, IN 46240
Phone (317) 537-9522

403 Walnut St
Ste A
Lawrenceburg, IN 47025
Phone (812) 537-2020

27 N Main St
Walton, KY 41094
Phone (859) 485-3937

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

575 White Pond Dr
Ste A
Akron, OH 44320
Phone (330) 835-1629

135 Merchant St
Ste 270
Cincinnati, OH 45246
Phone (513) 771-7483

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tyler.hudson.p19@direct.360care.nextgenshare.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1750518346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2343 ANTOINETTE WAY",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410917405",
            "telephone_number": "812-584-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 ANTOINETTE WAY",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410917405",
            "telephone_number": "812-584-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003584A",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5870",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1788DT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096984",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.