Family Vision and Eye Care PA
Organization Active NPI Optometrist · Rupert, ID
NPI 1043382609 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1043382609
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- FAMILY VISION AND EYE CARE PA
- Practice address
- 714 G St
Rupert, ID 83350-1612 - Phone
- (208) 436-3455
- Fax
- (208) 436-3195
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Todd Slusser, OD
- Title
- President
- Phone
- (208) 436-3455
Practitioners 2
-
Todd Gordon Slusser, O.D., M.S., F.A.A.O.
-
Elisabeth Erin Lehr, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Family Vision and Eye Care PA |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040218000964 | ID | Part B Supplier - Clinic/Group Practice | 8729973755 |
Receives reassigned benefits from 2 practitioners Practice locations: Rupert, ID |
| O20100930079434 | ID | DME Supplier - Physician - Optometrist | 8729973755 | Practice locations: Rupert, ID |
National Provider Directory
Locations
714 G St
Rupert, ID 83350
Phone (208) 436-3455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
714 G St
Rupert, ID 83350-1612
Mailing address
714 G St
Rupert, ID 83350-1612
Phone (208) 436-3455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4991580001 | Other | ID | DMERC NUMBER |
Other providers in Rupert, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.