Individual provider Active NPI

Joseph H Johnson, OD

  • Optometrist
  • Boise, ID
National Provider Identifier
1114418480
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10814339-9934 Issued in UT
Practice address
5761 W Hidden Springs Dr Ste 100
Boise, ID 83714-9453
Phone
(907) 225-2020
NPI assigned
May 22, 2018
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10814339-9934 UT Primary

Addresses

Primary practice location

5761 W Hidden Springs Dr Ste 100
Boise, ID 83714-9453

Mailing address

5761 W Hidden Springs Dr Ste 100
Boise, ID 83714-9453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, GA, AK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180924002810 NM Practitioner - Optometry 1557612926 Reassigns benefits to 1 organization
I20210615001537 GA Practitioner - Optometry 1557612926 Reassigns benefits to 1 organization
I20251014004227 AK Practitioner - Optometry 1557612926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vision CareGroup PAC ID 3375030539, 2 clinicians

Practice addresses (Care Compare)

351 Carlanna Lake Rd
Ketchikan, AK 99901-5614
Phone (907) 225-2020

Merit-based Incentive Payment System (MIPS)

Final score
98.81 of 100Reported as group
Quality
97.63
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10814339-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care Optometrist CurrentSince Aug 30, 2025 Accepting new patients
Hidden Springs Eye Care LLC Optometrist Current Accepting new patients
Georgia Vision Institute Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Georgia Vision Institute CurrentSince Jun 1, 2021 Accepting new patients

Locations

351 Carlanna Lake Rd
Ketchikan, AK 99901
Phone (907) 225-2020

300 Alabama Ave S
Bremen, GA 30110
Phone (678) 821-1880

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

158 Clinic Ave
Ste A
Carrollton, GA 30117
Phone (770) 834-1008

Organizations & group practices 5

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1114418480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 W HIDDEN SPRINGS DR STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 W HIDDEN SPRINGS DR STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149453",
            "telephone_number": "907-225-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSEPH",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "10814339-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.