Individual provider Active NPI

Jason Besecker, O.D.

  • Optometrist
  • Nampa, ID
National Provider Identifier
1114278447
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100254 Issued in ID
Practice address
3752 E Amity Ave Ste 103
Nampa, ID 83687-1221
Phone
(208) 490-8823
Fax
(208) 490-8525
NPI assigned
Sep 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100254 ID Primary
Optometrist 152W00000X 4943 MA

Addresses

Primary practice location

3752 E Amity Ave Ste 103
Nampa, ID 83687-1221

Mailing address

3752 E Amity Ave Ste 103
Nampa, ID 83687-1221
Phone (208) 490-8823

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
I20140820001193 ID Practitioner - Optometry 0345492906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1130 E Fairview Ave
Meridian, ID 83642-1813
Phone (208) 490-8823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4943MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Specialty Eyecare and Dry Eye Center PLLC Optometrist CurrentSince Jun 21, 2021 Accepting new patients

Locations

1130 E Fairview Ave
Meridian, ID 83642
Phone (208) 888-9393

Interoperability endpoints

  • Direct secure messaging: jbesecker@envision.intellechartdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1114278447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 E AMITY AVE STE 103",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836871221",
            "telephone_number": "208-490-8823",
            "fax_number": "208-490-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 E AMITY AVE STE 103",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836871221",
            "telephone_number": "208-490-8823",
            "fax_number": "208-490-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESECKER",
        "first_name": "JASON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100254",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.