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

Jackson Tyler Clark

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1245022540

Jackson Tyler Clark is an Optometry in Indianapolis, Indiana. Graduated from Indiana University - School of Optometry in 2025, 1 year ago. Practices with Myeyedr Optometry of Indiana LLC, a 80-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Trained at
Indiana University - School of Optometry
Licensed in
IN
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

6985 W 38th St Ste 100
Indianapolis, IN 46254-3918
Phone: (317) 243-0028
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 18004592A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1245022540
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 21, 2025
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolINDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Graduated 2025 (1 years in practice)
Group practice Myeyedr Optometry Of Indiana Llc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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