Individual provider Active NPI

Katherine Grill Nate, OD

  • Optometrist
  • Twin Falls, ID
National Provider Identifier
1023498037
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP100344 Issued in ID
Practice address
844 Shoshone St E
Twin Falls, ID 83301-6336
Phone
(208) 734-9800
Fax
(208) 734-9433
NPI assigned
Jun 4, 2015
Last updated
Aug 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP100344 ID Primary

Addresses

Primary practice location

844 Shoshone St E
Twin Falls, ID 83301-6336

Mailing address

844 Shoshone St E
Twin Falls, ID 83301-6336
Phone (208) 734-9800

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
I20160226002231 ID Practitioner - Optometry 5294030375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecenter PAGroup PAC ID 4486672565, 4 clinicians

Practice addresses (Care Compare)

844 Shoshone St E
Twin Falls, ID 83301-6336
Phone (208) 734-9800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP100344IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecenter PA Optometrist CurrentSince Jan 23, 2016 Accepting new patients
Eyecenter PA Optometrist CurrentSince Jan 23, 2016 Accepting new patients
Eyecenter PA Optometrist Past Accepting new patients

Locations

110 N 1st Ave
Hailey, ID 83333
Phone (208) 788-4120

201 S Lincoln Ave
Jerome, ID 83338
Phone (208) 324-4363

844 Shoshone St E
Twin Falls, ID 83301
Phone (208) 734-9800

Organizations & group practices 3

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1023498037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 SHOSHONE ST E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016336",
            "telephone_number": "208-734-9800",
            "fax_number": "208-734-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 SHOSHONE ST E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016336",
            "telephone_number": "208-734-9800",
            "fax_number": "208-734-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILL NATE",
        "first_name": "KATHERINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.