DR. TYLER KITZMAN O.D.
NPI 1164875787
Optometrist in Memphis, TN

Q: What is Tyler Kitzman's NPI number?

The NPI number for Tyler Kitzman is 1164875787. It was assigned to this individual provider in the NPPES registry on July 19, 2016.

Q: What is Tyler Kitzman's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Kitzman was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 19, 2016PECOS EnrolledAccepts Medicare Assignment

1225 MADISON AVE, MEMPHIS, TN 38104(901) 722-3250 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Sep 19, 2017 (3 updates tracked since 2017).

On this page

About Dr. Tyler Kitzman O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TYLER KITZMAN O.D. (NPI 1164875787) is an individual optometrist in Memphis, Tennessee, licensed in Tennessee (3407) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tahlequah, and is a graduate of Southern College Of Optometry (2016).

NPPES Registry Identity

NPI1164875787

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. TYLER KITZMANCredential: O.D.

Location Address1225 MADISON AVEMemphis, TN 38104-2211

Mailing Address1225 Madison AveMemphis, TN 38104-2211 · (901) 722-3250

Phone(901) 722-3250

Sole ProprietorNo

Medical School CMSSouthern College Of OptometryGraduated 2016

Enumeration DateJuly 19, 2016

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1164875787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in TN · 3407✔ Licensed in OK · 2891

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1225 MADISON AVE, Memphis, TN 38104

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Secondary Practice Location 1

Location 11001 N Grand AveTahlequah, OK 74464-7017 · Phone (918) 458-2108

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tyler Kitzman O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416243563

PECOS Enrollment IDI20171023001725

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Tyler Kitzman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern College Of Optometry

Same address

Optometrist

1225 MADISON AVE
Memphis, TN 38104

Reassigned Medicare billing, Tennessee enrollment
94 clinicians in this Medicare group

NPI 1851384986 (901) 722-3250

Cherokee Nation

264 mi

Multi-Specialty

471688 HIGHWAY 51
Stilwell, OK 74960

Reassigned Medicare billing, Texas enrollment
1,047 clinicians in this Medicare group

NPI 1992711345 (918) 696-8800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL GUNN FULLER O.D.

Optometrist