Lance W Fagan (NPI# 1891775151, PAC ID# 6305884917) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1891775151 |
| PAC ID by PECOS | 6305884917 |
| Professional Enrollment ID | I20050422000620 |
| Full Name | Lance W Fagan |
| Organization Legal Name | KOOTENAI VISION PLLC |
| Address |
1801 N 3rd St Coeur D Alene ID 83814-3400 |
| Phone Number | 2086671591 |
| Gender | M |
| Credential | OD |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2000 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 4284672890 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1801 N 3rd St, Coeur D Alene, ID 83814-3400 | 2086671591 | KOOTENAI VISION PLLC |
| 1101 E Polston Ave, Post Falls, ID 83854-6045 | 2087732020 | KOOTENAI VISION PLLC |
| 704 W College Ave, St Maries, ID 83861-1824 | 2082456563 | ST MARIES VISION CENTER PLLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 97% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 7% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 96% |
| Organization Legal Name | KOOTENAI VISION PLLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert John Johnson | Optometry | Kootenai Vision Pllc | 1801 N 3rd St, Coeur D Alene, ID 83814-3400 |
| Street Address |
1801 N 3RD ST |
| City | COEUR D ALENE |
| State | ID |
| Zip | 83814-3400 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert John Johnson | Optometry | Kootenai Vision Pllc | 1801 N 3rd St, Coeur D Alene, ID 83814-3400 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brent Earl Hirschi | Chiropractic | 610 N Hubbard St, Suite 114, Coeur D'alene, ID 83814 | |
| Sean Tristan T Cook | Infectious Disease | Kootenai Health | 2120 W Ironwood Dr, Coeur D Alene, ID 83814 |
| Dustin D Dinning | Rheumatology | Kootenai Health | 700 N Ironwood Dr, 275w, Coeur D'alene, ID 83814 |
| Natalie Rose Cooper | Physical Medicine and Rehabilitation | Kootenai Health | 2120 W Ironwood Dr, Coeur D Alene, ID 83814 |
| Melanie L Enderwick | Infectious Disease | Kootenai Health | 2120 W Ironwood Dr, Coeur D Alene, ID 83814 |
| Sarah R Nave | Registered Dietitian Or Nutrition Professional | Kootenai Health | 700 N Ironwood Dr, 275w, Coeur D'alene, ID 83814 |
| Orlando E Nunez | Podiatry | 101 W Ironwood Dr, Suite 131, Coeur D Alene, ID 83814-1404 | |
| Kevin M Johnson | General Surgery | Coeur D Alene Surgical and Vein | 608 Northwest Blvd, Coeur D Alene, ID 83814-2174 |
| Steven M Schlough | Clinical Social Worker | Ambitions of Idaho Inc | 1038 Northwest Blvd, Suite 100, Coeur D Alene, ID 83814-2249 |
| Jennifer Duncan | Clinical Social Worker | Ambitions of Idaho Inc | 1038 Northwest Blvd, Suite 100, Coeur D Alene, ID 83814-2249 |
| Find all physicians in zip 83814 | |||
| City | COEUR D ALENE |
| Zip Code | 83814 |
| Specialty | OPTOMETRY |
| City + Specialty | COEUR D ALENE + OPTOMETRY |
Please comment or provide details below to improve the information on Lance W Fagan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.