Landon Kelly Grange, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

M14219 Issued in ID

Practice address

5680 W Gage St
Boise, ID 83706

Phone

(208) 773-3937

Fax

(208) 377-3937

NPI assigned

Apr 28, 2014

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

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of California, San Diego School of Medicine, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S McCall Hospital, McCall, ID, CCN 131312

Merit-based Incentive Payment System (MIPS)

Final score

92.32 of 100Reported as individual

Quality

97.3

Improvement activities

40

Cost

78.01

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgrange@grangeeyecare.intellechartdirect.net

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

• Grange Ophthalmology, PLLC

  • Ophthalmology Physician
  • Eagle, ID
  • NPI 1285376558
  Medicare reassignment NPD
• Justin Rowe, O.D., P.a.

  • Optometrist
  • McCall, ID
  • NPI 1881021756
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes McCall LTD

  • Critical Access Hospital
  • McCall, ID
  • NPI 1235447970
  Care Compare affiliation

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1043620255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3867 MIRAMAR ST",
            "address_2": "APARTMENT G",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371312",
            "telephone_number": "208-559-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-773-3937",
            "fax_number": "208-377-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGE",
        "first_name": "LANDON",
        "middle_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M14219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043620255",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Grandfield, LCGC
• Grandmas Care Home Inc
• Brooklyn McNeil Grange
• Clarissa Dawn Grange, LMSW
• Daniel Lee Grange, D.O.
• Granite Mountain Surgery PLLC
• April Ann Grant, MD
• Barbara Lynn Grant, MS, RDN, CSO
• Halie Grant
• Kara Renee Grant, LPC

• Ophthalmology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.