NPIMap

Organization Active NPI

Boise Vision Care, P.a.

  • Optometrist
  • Boise, ID
National Provider Identifier
1134295116
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-683 Issued in ID
Legal business name
BOISE VISION CARE, P.A.
Practice address
3293 N Milwaukee St
Boise, ID 83704-4446
Phone
(208) 322-2020
Fax
(208) 322-1192
NPI assigned
Nov 28, 2006
Last updated
Aug 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Dr. Daniel R. Boespflug, O.D.NPI 1962441303
Title
President
Phone
(208) 322-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X ODP-683 ID
Optometrist 152W00000X ODP-683 ID Primary

Addresses

Primary practice location

3293 N Milwaukee St
Boise, ID 83704-4446

Mailing address

3293 N Milwaukee St
Boise, ID 83704-4446
Phone (208) 322-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100820000408 ID Part B Supplier - Clinic/Group Practice 4284768656 Receives reassigned benefits from 4 practitioners
Practice locations: Boise, ID
O20100930013020 ID DME Supplier - Physician - Optometrist 4284768656 Practice locations: Boise, ID

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Boise Vision Care PA3293 N Milwaukee St, Boise, ID 83704-4446(208) 322-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Oct 28, 1999

National Provider Directory

National Provider Directory

Locations

3293 N Milwaukee St
Boise, ID 83704
Phone (208) 322-2020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1134295116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3293 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-322-2020",
            "fax_number": "208-322-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3293 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-322-2020",
            "fax_number": "208-322-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE VISION CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "BOESPFLUG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-322-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ID",
            "license": "ODP-683",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.