Individual provider Active NPI

Matthew P Traynor, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Idaho Falls, ID
National Provider Identifier
1063563823
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
M-10686 Issued in ID
Practice address
2100 Providence Way
Idaho Falls, ID 83404
Phone
(208) 529-6600
Fax
(208) 529-6602
NPI assigned
Jan 16, 2007
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M-10686 ID
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X M-10686 ID Primary

Addresses

Primary practice location

2100 Providence Way
Idaho Falls, ID 83404

Mailing address

2100 Providence Way
Idaho Falls, ID 83404-4951
Phone (208) 529-6600

Other identifiers 1

IdentifierTypeStateIssuer
808405700MedicaidID

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090722000330 ID Practitioner - Ophthalmology 6305998352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Virginia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Care of Eastern IdahoGroup PAC ID 2466611744, 11 clinicians

Practice addresses (Care Compare)

2100 Providence Way
Idaho Falls, ID 83404-4951
Phone (208) 529-6600

Merit-based Incentive Payment System (MIPS)

Final score
92.96 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-10686IDMDOphthalmology Physician
24632OKMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henrys Fork Surgery Center PLLC CurrentSince May 4, 2020 Accepting new patients
Premier Eye Care of Eastern Idaho Ophthalmology CurrentSince Dec 21, 2011 Accepting new patients
Center for Sight PLLC Ophthalmology PastSince Jun 10, 1996 Accepting new patients

Locations

2100 Providence Way
Idaho Falls, ID 83404
Phone (208) 529-6600

23 Sawtelle Ave
#101
Rexburg, ID 83440
Phone (208) 356-0070

23 Sawtelle Ave
#102
Rexburg, ID 83440
Phone (208) 359-1888

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1063563823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044951",
            "telephone_number": "208-529-6600",
            "fax_number": "208-529-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-6600",
            "fax_number": "208-529-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYNOR",
        "first_name": "MATTHEW",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M-10686",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "ID",
            "license": "M-10686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808405700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.