TEDDER OPTOMETRIC CLINIC MANAGEMENT, P.C.
NPI 1851091805
Optometrist in Fontana, CA
About Tedder Optometric Clinic Management, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TEDDER OPTOMETRIC CLINIC MANAGEMENT, P.C. (NPI 1851091805) is a healthcare organization registered as an optometrist in Fontana, California and active in the NPI registry since March 2023. The organization maintains 2 additional practice locations and lists Taylor Dean Tedder, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tedder Optometric Clinic Management, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Tedder Optometric Clinic Management, P.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Tedder Optometric Clinic Management, P.C.'s NPI number?
The NPI number for Tedder Optometric Clinic Management, P.C. is 1851091805. It was assigned to this organization in the NPPES registry on March 8, 2023.
Where is Tedder Optometric Clinic Management, P.C. located?
Tedder Optometric Clinic Management, P.C. is located at 17064 Slover Ave Ste 104, Fontana, CA 92337. The listed phone number is (909) 258-4620.
What is Tedder Optometric Clinic Management, P.C.'s specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Tedder Optometric Clinic Management, P.C. enrolled in Medicare?
Yes. Tedder Optometric Clinic Management, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tedder Optometric Clinic Management, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Optometry, reassign their Medicare billing to Tedder Optometric Clinic Management, P.C.. A 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 the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Tedder Optometric Clinic Management, P.C. was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.
# Tedder Optometric Clinic Management, P.c. · NPI 1851091805
Optometrist organization in Fontana, California. Organization record, active in the CMS NPPES registry since March 8, 2023.
## Identity
- **NPI:** 1851091805 (Entity type: Organization)
- **Enumerated:** March 8, 2023
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Taylor Tedder, PRESIDENT
## Practice location
- **Address:** 17064 SLOVER AVE STE 104, Fontana, CA 92337-7592
- **Phone:** (909) 258-4620
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1851091805) · Data from the CMS NPPES public registry.