Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Tyler Phan, OD

Individual provider Optometrist · NPI 1306250931

Dr. Tyler Phan, OD is an Optometry in Newburgh, New York. Qualified in 2014, 12 years ago. Practices with Cornerstone Family Healthcare, a 66-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2014
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

147 Lake St
Newburgh, NY 12550-5263
Phone: (845) 563-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence TUV008145 (NY)

Record details

NPI number1306250931
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJune 11, 2014
Last updated in NPPESMay 28, 2024
Certification dateMay 28, 2024
Mailing address2570 Route 9w Ste 10, Cornwall, NY 12518-1370

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Cornerstone Family Healthcare — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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