Tyrel J Bruneel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP100469 Issued in ID

Practice address

8445 N Government Way
Hayden, ID 83835-9280

Phone

(208) 772-3208

Fax

(208) 762-2574

NPI assigned

Jun 5, 2019

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hayden Vision Source PLLCGroup PAC ID 6800282427, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hayden Vision Source PLLC

  dba Hayden Vision Source

  • Optometrist
  • Hayden, ID
  • NPI 1548999840
  Medicare reassignment Care Compare group NPD
• Hayden Vision Center P.a.

  • Specialist
  • Hayden, ID
  • NPI 1407975873
  Medicare reassignment NPD
• Hayden Vision Source PLLC

  • Optometrist
  • Hayden, ID
  • NPI 1780345264
  NPD (past) Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1013575851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8445 N GOVERNMENT WAY",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359280",
            "telephone_number": "208-772-3208",
            "fax_number": "208-762-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 N GOVERNMENT WAY",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359280",
            "telephone_number": "208-772-3208",
            "fax_number": "208-762-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNEEL",
        "first_name": "TYREL",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brown Family Chiropractic LLC (Brown Family Chiropractic)
• Bradley Scott Brown, MT
• Emily Sarah Brown, DPT, OCS
• Jackson Batterson Brown, DC
• Jennie Rose Brown, PHARMD
• Mark Dana Bullock, PH.D.
• Laura K. Burgeson, PA-C
• Shawn Lee Burke, PTA
• Daryll Butler, RPH
• Scout Moon-Shun Cai, DPT

• Optometrist in Hayden, ID
• Providers in Hayden, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.