Maple Grove Eyecare PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

MAPLE GROVE EYECARE PC

Practice address

8955 W Hackamore Dr
Boise, ID 83709

Phone

(208) 344-7944

Fax

(208) 343-4676

NPI assigned

May 13, 2019

Organization subpart

No

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

Authorized official

Name

Matthew D Neale, MDNPI 1184885345

Title

Practice Owner/Ophthalmologist

Phone

(541) 687-1715

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Interoperability endpoints

• Direct secure messaging: mneale@mgeye.intellechartdirect.net
• Direct secure messaging: jmcadams@mgeye.intellechartdirect.net

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew D Neale, MD

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1184885345
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua Earl McAdams, O.D.

  • Optometrist
  • Boise, ID
  • NPI 1326302548
  Medicare reassignment Care Compare group NPD
• Jacob Adam Mong, D.O.

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1346535481
  Medicare reassignment NPD
• Jacob Evans

  • Ophthalmology Physician
  • Madison, WI
  • NPI 1447784384

  ID

  Medicare reassignment NPD

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1124684485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091673",
            "telephone_number": "208-344-7944",
            "fax_number": "208-343-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-344-7944",
            "fax_number": "208-343-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE GROVE EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "NEALE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE OWNER/OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "541-687-1715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184885345",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Mantey, LMSW
• Savarra Marie Mantzor, M.D.
• Claryce Manweiler
• Kamille Eldene Ariel Manzo, LMSW
• Valer Mapendo, LMSW
• Maple Grove Surgical LLC
• Kelci Denae Mar, DPT
• Roberta Mendiola Maratita
• Marc Bostick MD Chartered
• Lesley March

• Ophthalmology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.