Tedder Optometric Clinic Management, P.c. - Medicare Optometrist in Fontana, CA

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Tedder Optometric Clinic Management, P.c. is a medicare enrolled "Optometrist" provider in Fontana, California. Their current practice location is 17064 Slover Ave Ste 104, Fontana, California. You can reach out to their office (for appointments etc.) via phone at (909) 258-4620.

Tedder Optometric Clinic Management, P.c. is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Tedder Optometric Clinic Management, P.c. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1851091805.

Contact Information

Tedder Optometric Clinic Management, P.c.
17064 Slover Ave Ste 104,
Fontana, CA 92337-7592
(909) 258-4620
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameTedder Optometric Clinic Management, P.c.
TypeFacility
SpecialityOptometrist
Location17064 Slover Ave Ste 104, Fontana, California
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1851091805
  • Provider Enumeration Date: 03/08/2023
  • Last Update Date: 08/25/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7012371263
  • Enrollment ID: O20230907000242

Medical Identifiers

Medical identifiers for Tedder Optometric Clinic Management, P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1851091805NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Tedder Optometric Clinic Management, P.c. acts as a billing entity for following providers:
Provider NameMichael Vathanasaynee
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1083810212
PECOS PAC ID: 8325026685
Enrollment ID: I20040712001622
Provider NameTaylor D Tedder
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1639364532
PECOS PAC ID: 6406944891
Enrollment ID: I20071119000405
Provider NameMousami R Paver
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1154514495
PECOS PAC ID: 0446315170
Enrollment ID: I20150708003236
Provider NameEmmy Thai
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1558953661
PECOS PAC ID: 1951798362
Enrollment ID: I20220503000746
Provider NameLaura Leticia Garnica
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1598348468
PECOS PAC ID: 5799150710
Enrollment ID: I20230405001042
Provider NameMai-anh Bui
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1396999603
PECOS PAC ID: 7416311402
Enrollment ID: I20230908002494
Provider NameAntoinette Lam Vu
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1720602345
PECOS PAC ID: 6002260148
Enrollment ID: I20230925000059
Provider NameKyrillos Zaki
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1215718804
PECOS PAC ID: 6800245556
Enrollment ID: I20231207000851
Provider NameKhanh Dang
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1346083755
PECOS PAC ID: 3779021936
Enrollment ID: I20240819003449
Provider NamePhoebe Hoang
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1558154104
PECOS PAC ID: 1254841224
Enrollment ID: I20250609002582

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. Tedder Optometric Clinic Management, P.c. 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 AddressPractice Location Address
Tedder Optometric Clinic Management, P.c.
530 New Los Angeles Ave Ste 115-269,
Moorpark, CA 93021-2081

Ph: (805) 624-1255		Tedder Optometric Clinic Management, P.c.
17064 Slover Ave Ste 104,
Fontana, CA 92337-7592

Ph: (909) 258-4620

Reviews and Comments


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Junyao Xu, OD
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Dr. Matthew M. Enos, O.D.
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Practice Location: 8190 Mango Ave, Fontana, CA 92335
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Theprangsy Nantha, OD
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Medicare: Medicare Enrolled
Practice Location: 9961 Sierra Ave, Fontana, CA 92335
Phone: 909-427-3910    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.