Tyler S Rose, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005104 Issued in MI

Practice address

330 W Lake Lansing Rd
East Lansing, MI 48823-8527

Phone

(517) 337-8182

Fax

(517) 332-0038

NPI assigned

Jan 30, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Eye Care PCGroup PAC ID 4587635420, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Valley Eye Care P C

  • Optometrist
  • Corvallis, OR
  • NPI 1275655391
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1454112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1942668389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208177",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208177",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238527",
            "telephone_number": "517-337-8182",
            "fax_number": "517-332-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5961 LOS ALTOS PKWY",
            "address_2": "STE 101",
            "address_purpose": "LOCATION",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894362501",
            "country_code": "US",
            "telephone_number": "775-359-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 N Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483411166",
            "country_code": "US",
            "telephone_number": "248-332-2895",
            "fax_number": "248-332-4896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2117 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489123231",
            "country_code": "US",
            "telephone_number": "517-485-2213",
            "fax_number": "517-485-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 N Main",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "MI",
            "postal_code": "488725103",
            "country_code": "US",
            "telephone_number": "517-339-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Marshall St",
            "address_purpose": "LOCATION",
            "city": "Coldwater",
            "state": "MI",
            "postal_code": "490361175",
            "country_code": "US",
            "telephone_number": "517-278-6303",
            "fax_number": "517-278-8656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "56847 N Main St",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490939615",
            "country_code": "US",
            "telephone_number": "269-273-2020",
            "fax_number": "269-279-6010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 Marsh Rd",
            "address_purpose": "LOCATION",
            "city": "Haslett",
            "state": "MI",
            "postal_code": "488408987",
            "country_code": "US",
            "telephone_number": "517-339-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TYLER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "905",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather E Rosales, LMSW
• Hayley Rose
• Mercuri O Rose
• Miko Rose, D.O.
• Robert P Rose, DO
• Alexandra Marie Rosell, O.T.
• Lionel W Rosen, M.D.
• Rachel Ann Rosenbaum, DO
• Robert Warren Rosenbaum, MD
• Kenneth Daniel Rosenman, M.D.

• Optometrist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.