Jackson Tyler Clark
NPI 1245022540ActiveIndividual· Optometrist· Indianapolis, IN
Optometrist in Indianapolis, Indiana, trained at Indiana University - School of Optometry (class of 2025). Enrolled in Medicare as practitioner - optometry.
Overview
| NPI | 1245022540 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | May 21, 2025 |
| Last updated in NPPES | Jul 24, 2025 |
| Certified by provider | Jul 24, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 18004592A | IN |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Optometry (IN) |
|---|
Education and affiliations
| Medical school | Indiana University - School of Optometry |
|---|---|
| Graduation year | 2025 |
| Medicare specialty | Optometry |
Medical group
- Myeyedr Optometry of Indiana LLCIndianapolis, IN · 81 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 335 optometrists in Indianapolis · All optometrists in Indiana