Stacie Zollman

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100284 Issued in ID

Practice address

872 Troy Rd Ste 130
Moscow, ID 83843-5035

Phone

(208) 883-1800

NPI assigned

Jul 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson Polito PLLCGroup PAC ID 9931386174, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Wilson Polito PLLC

  • Optometrist
  • Lewiston, ID
  • NPI 1710276324
  Medicare reassignment Care Compare group NPD
• Stephen Brockbank O.D. L.L.C.

  • Optometrist
  • Lewiston, ID
  • NPI 1750511184
  NPD (past)

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1124373410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 W PULLMAN RD",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838434014",
            "telephone_number": "208-310-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 TROY RD STE 130",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838435035",
            "telephone_number": "208-883-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLMAN",
        "first_name": "STACIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle D Zahn
• Tyler Paul Zaugg, OD
• Lingwen Zhang
• Noah Ziemann
• Allison Lea Zimms
• Chantel Zuercher, LPC, NCC
• Lennard Zylstra

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.