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

Dr. Tyler Ray Bellack, OD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1750074621

Dr. Tyler Ray Bellack, OD is an Optometry in Kennesaw, Georgia. Graduated from University Alabama Birmingham - School of Optometry in 2023, 3 years ago. Practices with Perimeter Vision Care LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
3
Trained at
University Alabama Birmingham - School of Optometry
Licensed in
GA
In the registry since
2023
Specialties on file
2
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

400 Ernest W Barrett Pkwy NW Ste 617
Kennesaw, GA 30144-4997
Phone: (772) 272-9470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT003500 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1750074621
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 29, 2023
Last updated in NPPESJuly 3, 2023
Certification dateJuly 3, 2023
Mailing address3338 Littleport Ln Nw, Acworth, GA 30101-6972

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
Graduated 2023 (3 years in practice)
Group practice Perimeter Vision Care Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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