DR. TYLER DALLIN BOULTER MD
NPI 1730683970
Ophthalmology in Portland, OR

Active since March 22, 2018PECOS EnrolledAccepts Medicare Assignment
95.31/100
CMS Quality Rating
9135 SW BARNES RD STE 961, PORTLAND, OR 97225(503) 292-0848(503) 296-0635 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 20, 2023, Jun 8, 2023, Aug 11, 2022 and 1 more (4 updates tracked since 2018).

About Dr. Tyler Dallin Boulter Md NPPES

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

DR. TYLER DALLIN BOULTER MD (NPI 1730683970) is an individual ophthalmology provider in Portland, Oregon, licensed in Oregon (MD215593) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Texas A & M University System, Hsc, College Of Medicine (2018).

NPPES Registry Identity

NPI1730683970
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. TYLER DALLIN BOULTERCredential: MD
Location Address9135 SW BARNES RD STE 961Portland, OR 97225-6699
Mailing AddressPo Box 22009Portland, OR 97269-2009 · (503) 558-7372 · Fax (503) 344-5140
Fax(503) 296-0635
Sole ProprietorNo
Medical School CMSTexas A & M University System, Hsc, College Of MedicineGraduated 2018
Enumeration DateMarch 22, 2018
Last NPPES UpdateJune 20, 20234 updates tracked since enumeration
NPPES CertifiedJune 20, 2023
NPI 1730683970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in OR · MD215593 Licensed in NH · 22178
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

9135 SW BARNES RD STE 961, Portland, OR 97225

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Tyler Dallin Boulter Md 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 ID1355676644
PECOS Enrollment IDI20230609002057
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.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
383 services328 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
322 services245 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
178 services164 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
123 services112 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
109 services104 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
107 services80 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence St Vincent Medical Center

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380004
Location9205 SW Barnes RoadPortland, OR 97225 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97225 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
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost84.37

Other Providers at the Same Location NPPES 6

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

Ophthalmology
9135 SW BARNES RD STE 961
PORTLAND, OR 97225
Ophthalmology
9135 SW BARNES RD STE 961
PORTLAND, OR 97225
Optometrist
9135 SW BARNES RD STE 961
PORTLAND, OR 97225
Optometrist
9135 SW BARNES RD STE 961
PORTLAND, OR 97225
Optometrist
9135 SW BARNES RD STE 961
PORTLAND, OR 97225
Ophthalmology
9135 SW BARNES RD STE 961
PORTLAND, OR 97225

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1730683970, enumerated as an "individual" on March 22, 2018.

The provider is located at 9135 SW BARNES RD STE 961 PORTLAND, OR 97225 and the phone number is (503) 292-0848.

Ophthalmology with taxonomy code 207W00000X.

The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente, Moda. Please consult your insurance carrier or call the provider to verify.

Tyler Boulter is affiliated with: PROVIDENCE ST VINCENT MEDICAL CENTER.