Tyler Robertson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

924 Issued in NV

Practice address

1250 Great Basin Blvd
Ely, NV 89301-2096

Phone

(775) 289-2580

NPI assigned

Jul 5, 2017

Last updated

Feb 15, 2023By 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 TX, NV2 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

JC Edwards School of Medicine, Marshall University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Robertson Optometry LLC

  • Optometrist
  • Ely, NV
  • NPI 1467164079
  Medicare reassignment NPD Authorized official
• Girisgen & Kopolow OD, PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1427382415
  Medicare reassignment NPD
• Kopolow & Girisgen Professional Corporation

  dba Kopolow & Girisgen OD PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1518904622
  Medicare reassignment NPD
• Anadarko Indian Health Center

  • Federal Public Health Clinic/Center
  • Anadarko, OK
  • NPI 1881637403

  TX

  Medicare reassignment NPD
• Carnegie Indian Health Center

  • Federal Public Health Clinic/Center
  • Carnegie, OK
  • NPI 1457459158

  TX

  Medicare reassignment NPD
• Girisgen & Kopolow OD, PC

  dba Pearle Vision Nellis

  • Optometrist
  • Las Vegas, NV
  • NPI 1457716391
  NPD
• Girisgen & Kopolow OD, PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1841523164
  NPD

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1891216388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 AVENUE N",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893012904",
            "telephone_number": "775-293-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 GREAT BASIN BLVD",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893012096",
            "telephone_number": "775-289-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "TYLER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A. Rhodes, M.D.
• Ridley's Family Markets, Inc (Ridley's Clinic Pharmacy)
• Ridley's Family Markets, Inc (Ridley's Pharmacy #1154)
• Robertson Optometry LLC
• Kent Mitchell Robertson, O.D.
• Natlie Marina Salinas
• Brigette Elise Saltarelli, CCC-SLP
• Sanderling Renal Services-USA, LLC (Sanderling Dialysis Center - ELY)
• Sarc Nevada LLC
• Mandy Sue Schaefer

• Optometrist in Ely, NV
• Providers in Ely, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.