TAYLOR D TEDDER O.D.
NPI 1639364532
Optometrist in Moorpark, CA
About Taylor D Tedder O.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TAYLOR D TEDDER O.D. (NPI 1639364532) is an individual optometrist in Moorpark, California, licensed in California (13350) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Thousand Oaks.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Taylor D Tedder O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Taylor Tedder reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Dimas, CA 91773
- Reassigned Medicare billing, California enrollment
- 6 clinicians in this Medicare group
Fontana, CA 92337
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Tedder Optometric Clinic Management, PC
- 10 clinicians in this Medicare group
Everett, WA 98208
- Reassigned Medicare billing, Washington enrollment
- 25 clinicians in this Medicare group
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 93021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Taylor Tedder's NPI number?
The NPI number for Taylor Tedder is 1639364532. It was assigned to this individual provider in the NPPES registry on September 13, 2007.
Where is Taylor Tedder located?
Taylor Tedder practices at 766 W Los Angeles Ave D3, Moorpark, CA 93021. The listed phone number is (805) 523-3440.
What is Taylor Tedder's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Taylor Tedder enrolled in Medicare?
Yes. Taylor Tedder is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Taylor Tedder's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Taylor Tedder reassigns Medicare benefits to 3 organizations: Tedder Optometry Group, PC (San Dimas, CA), Tedder Optometric Clinic Management, P.C. (Fontana, CA) and Blue Wave Eye Doctors Professional Limited Liability Company (Everett, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Taylor Tedder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Taylor Tedder accept?
Health plans from Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana list Taylor Tedder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Taylor Tedder was last updated on August 30, 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.
# Taylor D Tedder, O.D. · NPI 1639364532
Optometrist provider in Moorpark, California. Individual provider, active in the CMS NPPES registry since September 13, 2007.
## Identity
- **NPI:** 1639364532 (Entity type: Individual)
- **Enumerated:** September 13, 2007
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 13350 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 766 W LOS ANGELES AVE, D3, Moorpark, CA 93021-9302
- **Phone:** (805) 523-3440
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Tedder Optometry Group, PC (NPI 1184484222, San Dimas, CA); Tedder Optometric Clinic Management, P.C. (NPI 1851091805, Fontana, CA); Blue Wave Eye Doctors Professional Limited Liability Company (NPI 1053060475, Everett, WA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 30, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1639364532) · Data from the CMS NPPES public registry.