Dr Tylor Pravongviengkham, OD in Gilbert, AZ - Medicare Optometrist Provider

Dr Tylor Pravongviengkham, OD is a medicare enrolled "Optometrist" provider in Gilbert, Arizona. His current practice location is 3303 E Baseline Rd Ste 104, Gilbert, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 632-2020.

Dr Tylor Pravongviengkham is licensed to practice in Arizona (license number OPT-002670) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1235880493.

Contact Information

	Dr Tylor Pravongviengkham, OD
	3303 E Baseline Rd Ste 104, Gilbert, AZ 85234-2739
	(480) 632-2020
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Tylor Pravongviengkham
Gender	Male
Speciality	Optometrist
Location	3303 E Baseline Rd Ste 104, Gilbert, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235880493
Provider Enumeration Date: 01/10/2022
Last Update Date: 02/27/2023

Medicare PECOS Information:

PECOS PAC ID: 0345614210
Enrollment ID: I20230414002009

Medical Identifiers

Medical identifiers for Dr Tylor Pravongviengkham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235880493	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	OPT-002670 (Arizona)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tylor Pravongviengkham allows following entities to bill medicare on his behalf.

Provider Name	Richard E Wood Od And Associates Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1013940824 PECOS PAC ID: 9234139320 Enrollment ID: O20090819000905

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tylor Pravongviengkham is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Tylor Pravongviengkham, OD 3303 E Baseline Rd Ste 104, Gilbert, AZ 85234-2739 Ph: (480) 632-2020	Dr Tylor Pravongviengkham, OD 3303 E Baseline Rd Ste 104, Gilbert, AZ 85234-2739 Ph: (480) 632-2020

Reviews and Comments

Optometrist in Gilbert, AZ

Marci Pieper, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3921 E. Baseline Rd., Suite 8, Gilbert, AZ 85234 Phone: 480-892-6560
Dr. John Andrew Riley, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3931 S Gilbert Rd, Gilbert, AZ 85297 Phone: 480-281-0204 Fax: 480-281-0206
Dr. Karen Stonebraker Simon, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 690 E Warner Rd, Suite 128, Gilbert, AZ 85296 Phone: 480-248-6173 Fax: 480-240-5972
Dr. Jonathan Egan Wold, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2680 S Val Vista Dr, #111, Gilbert, AZ 85295 Phone: 480-807-0288 Fax: 480-290-7199
Steven L. Labroff, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2174 E Williams Field Rd, Ste 124, Gilbert, AZ 85295 Phone: 480-786-9845
Irina Andrushenko, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2450 E Guadalupe Rd Ste 107, Gilbert, AZ 85234 Phone: 480-558-0600
Mr. Alma D. Yamamoto, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 67 S Higley Rd Ste 104, Gilbert, AZ 85296 Phone: 480-219-5175 Fax: 480-935-0623

Dr Tylor Pravongviengkham, OD - Medicare Optometrist in Gilbert, AZ