Amy Marie Neideffer

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100618 Issued in ID

Practice address

1702 S Kimball Ave
Caldwell, ID 83605-4826

Phone

(208) 459-2641

Fax

(208) 459-2895

NPI assigned

May 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Idaho Eyecare CenterGroup PAC ID 9335105311, 4 clinicians

Micah S Mills OD PAGroup PAC ID 6305038365, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Idaho Eyecare Center

  • Optometrist
  • Boise, ID
  • NPI 1992899181
  Medicare reassignment Care Compare group NPD
• Micah S Mills OD PA

  • Corneal and Contact Management Optometrist
  • Caldwell, ID
  • NPI 1972819365
  Medicare reassignment Care Compare group NPD
• Total Vision PA

  • Corneal and Contact Management Optometrist
  • Caldwell, ID
  • NPI 1447328463
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1114663291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054826",
            "telephone_number": "208-459-2641",
            "fax_number": "208-459-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDEFFER",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3189",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantell Amanda Navarro, LPC
• Paloma Neal
• Cordell Denton Nebeker, D.D.S., M.S.
• Sadie J Nebeker, LCSW
• Diana Sullivan Neff, PMHNP
• Jeannie Nejely
• James D Nelson, RPH
• James Nettleton, RN
• Etta Kathryn Nevel, MD
• New Smile Inc.

• Optometrist in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.