Adams Eyecare Inc
Organization Active NPI Optometrist · Eagle, ID
NPI 1063759199 · NPPES record last updated Apr 19, 2021
Key facts
- NPI
- 1063759199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- ODP-1041 (ID)
- Legal business name
- ADAMS EYECARE INC
- Practice address
- 3541 W Bavaria St
Eagle, ID 83616-6318 - Phone
- (208) 939-5005
- Fax
- (208) 939-2496
- NPI assigned
- Jan 9, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Adam Heiner, OD
- Title
- President
- Phone
- (208) 283-8815
Practitioners 2
-
Adam Heiner, O.D.
-
Amber L Simonson, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130325000154 | ID | Part B Supplier - Clinic/Group Practice | 5991940850 |
Receives reassigned benefits from 2 practitioners Practice locations: Eagle, ID; Nampa, ID |
National Provider Directory
Locations
3541 W Bavaria St
Eagle, ID 83616
Phone (208) 939-5005
2103 N Cassia St
Nampa, ID 83651
Phone (208) 465-0088
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | ODP-1041 | ID | Yes |
Addresses
Primary practice location
3541 W Bavaria St
Eagle, ID 83616-6318
Mailing address
3541 W Bavaria St
Eagle, ID 83616-6318
Phone (208) 939-5005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992792469 | Medicaid | ID |
Other names
- Adam's Eyecare
Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.