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

Q: What is Tyler Boulter's NPI number?

The NPI number for Tyler Boulter is 1730683970. It was assigned to this individual provider in the NPPES registry on March 22, 2018.

Q: What is Tyler Boulter's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Boulter was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 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: October 18, 2026.

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

On this page

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

Phone(503) 292-0848

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

9135 SW BARNES RD STE 961, Portland, OR 97225

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BridgeSpan Health Company, Kaiser Permanente 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 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.

Medicare Billing Reassignment

Medicare enrollment records show Tyler Boulter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Eye Health Northwest, PC

8.5 mi

Ophthalmology

11086 SE OAK ST, ADMINISTRATION
Milwaukie, OR 97222

Reassigned Medicare billing, Oregon enrollment
85 clinicians in this Medicare group

NPI 1619959731 (503) 557-2020

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

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the 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

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

88 services88 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

84 services84 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

81 services49 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

35 services35 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

27 services27 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

18 services18 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

16 services16 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

Quality

100

Promoting Interoperability

100

Improvement Activities

Cost

84.37

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.

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