Individual provider Active NPI

Brandon Fish, O.D.

  • Optometrist
  • Twin Falls, ID
National Provider Identifier
1003015363
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP100141 Issued in ID
Practice address
731 N College Rd
Twin Falls, ID 83301-3382
Phone
(208) 734-3937
Fax
(208) 734-7585
NPI assigned
Jul 16, 2007
Last updated
Apr 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP100141 ID Primary

Addresses

Primary practice location

731 N College Rd
Twin Falls, ID 83301-3382

Mailing address

731 N College Rd
Twin Falls, ID 83301-3382
Phone (208) 734-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070831000590 ID Practitioner - Optometry 4385737600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific Medical College, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

731 N College Rd
Twin Falls, ID 83301-3382
Phone (208) 734-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP100141IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Optical Inc Optometrist CurrentSince Jul 9, 2007 Accepting new patients
Cheaper Peepers LLC Optometrist PastSince Jul 9, 2007 Accepting new patients

Locations

731 N College Rd
Twin Falls, ID 83301
Phone (208) 734-3937

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1003015363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N COLLEGE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013382",
            "telephone_number": "208-734-3937",
            "fax_number": "208-734-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N COLLEGE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013382",
            "telephone_number": "208-734-3937",
            "fax_number": "208-734-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.