ADA COUNTY EYECARE, P.C. (NPI# 1619185485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619185485 |
| Entity Type | Organization |
| Organization Name | ADA COUNTY EYECARE, P.C. |
| Practice Address |
2069 E Feldspar Ct Boise ID 83712-8456 |
| Practice Telephone | 2088691965 |
| Practice Fax Number | 2083451137 |
| Mailing Telephone | 2088691965 |
| Mailing Fax Number | 2083451137 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2011-12-06 |
| Authorized Official Name | STEVEN M. POLATIS (PRESIDENT) |
| Authorized Official Telephone | 2088691965 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
ODP-900 | ID | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 804046000 | 05 | |
| DEA NUMBER | MPO700802 | 01 |
| Street Address |
2069 E FELDSPAR CT |
| City | BOISE |
| State | ID |
| Zip Code | 83712-8456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285759753 | Brent Anthony Galvan | Optometrist | 8102 W Northview St, Boise, ID 83704-4406 | 2007-03-20 |
| 1194823930 | Deborah Ann Amato | Optometrist | 8641 W Franklin, Boise, ID 83709 | 2006-09-20 |
| 1821082470 | Lance F Ough | Optometrist | 350 N Milwaukee St, #2153, Boise, ID 83704-9123 | 2005-09-08 |
| 1447540802 | Cole Family Eye Center, Pa | Optometrist | 8102 W Northview St, Boise, ID 83704 | 2011-04-19 |
| 1033302161 | Rob Dee Christensen | Optometrist | 1410 Broadway Ave, Boise, ID 83706-3706 | 2007-08-22 |
| 1861408379 | D. H. Pitkin | Optometrist | 6700 W Emerald St, Boise, ID 83704-8727 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700163839 | Nicholas J Kelsey | Optometrist | 503 Broadway Ave S, Suite A, Buhl, ID 83316-1312 | 2011-11-03 |
| 1174524722 | Kenneth William King Jr. | Optometrist | 1480 E Lincoln Rd, Idaho Falls, ID 83401-2128 | 2005-08-04 |
| 1427256288 | Scott Burns Taylor | Optometrist | 1301 Main St, Suite 10, Salmon, ID 83467-4453 | 2007-07-03 |
| 1538388624 | Sparhawk Vision, Chtd | Optometrist | 2025 12th Ave Rd, Suite 100, Nampa, ID 83686-6459 | 2007-04-25 |
| 1225178593 | Douglass Eugene Hanson | Optometrist | 24 E Main St, Rexburg, ID 83440-1927 | 2007-02-07 |
| 1942316054 | Alan Richard Smith | Optometrist | 2100 12th Ave Rd, Nampa, ID 83686-6441 | 2006-08-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.