Individual provider Active NPI

Cadence Brunzlick, OD

  • Optometrist
  • Caldwell, ID
National Provider Identifier
1114501681
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
100532 Issued in ID
Practice address
1906 Fairview Ave
Caldwell, ID 83605-5407
Phone
(208) 459-2020
NPI assigned
May 10, 2021
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 100532 ID Primary

Addresses

Primary practice location

1906 Fairview Ave
Caldwell, ID 83605-5407

Mailing address

1906 Fairview Ave Ste 100
Caldwell, ID 83605-5433
Phone (208) 459-2020

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
I20210619000041 ID Practitioner - Optometry 9638579238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eyecare Specialists PLLCGroup PAC ID 0749350650, 8 clinicians

Practice addresses (Care Compare)

420 E Elm St
Caldwell, ID 83605-4846
Phone (208) 459-3366

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100532IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare Specialists PLLC Optometrist CurrentSince Jun 4, 2021 Accepting new patients
Vision Quest Medical Center, PA Optometrist PastSince May 16, 2021 Accepting new patients
Insight Optical Optometrist PastSince Jun 4, 2021 Accepting new patients

Locations

1906 Fairview Ave
Caldwell, ID 83605
Phone (208) 385-3680

1906 Fairview Ave
Ste 100
Caldwell, ID 83605
Phone (208) 377-3937

420 E Elm St
Caldwell, ID 83605
Phone (208) 459-2020

Interoperability endpoints

  • FHIR API: https://familyeyes.ef.prod.fhir.ema-api.com/fhir/r4/

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": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1114501681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 100",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055433",
            "telephone_number": "208-459-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055407",
            "telephone_number": "208-459-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNZLICK",
        "first_name": "CADENCE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.