Individual provider Active NPI

Dustin J Jones, OD

  • Corneal and Contact Management Optometrist
  • Salmon, ID
National Provider Identifier
1174612394
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
ODP-100011 Issued in ID
Practice address
1301 Main St
Suite 10
Salmon, ID 83467-4451
Phone
(208) 756-2020
Fax
(208) 756-3741
NPI assigned
Oct 12, 2006
Last updated
Mar 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5156353-9934 UT
Corneal and Contact Management Optometrist 152WC0802X ODP-100011 ID Primary

Addresses

Primary practice location

1301 Main St
Suite 10
Salmon, ID 83467-4451

Mailing address

1301 Main St
Suite 10
Salmon, ID 83467-4451
Phone (208) 756-2020

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
I20070828000799 ID Practitioner - Optometry 3870539786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 S 12TH St
Challis, ID 83226-7818
Phone (208) 879-2783

Merit-based Incentive Payment System (MIPS)

Final score
93.68 of 100Reported as individual
Quality
87.36
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5156353-9934UTMDOptometrist
ODP-100011IDMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Salmon River Vision Clinic, PLLC Optometrist CurrentSince Feb 1, 2012 Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Scott Burns Taylor Optometrist Past Accepting new patients
Standard Optical Company Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients

Locations

1301 Main St
Ste 10
Salmon, ID 83467
Phone (208) 756-2020

603 Shoup St
Salmon, ID 83467
Phone (208) 756-2020

Organizations & group practices 10

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1174612394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MAIN ST",
            "address_2": "SUITE 10",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674451",
            "telephone_number": "208-756-2020",
            "fax_number": "208-756-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MAIN ST",
            "address_2": "SUITE 10",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674451",
            "telephone_number": "208-756-2020",
            "fax_number": "208-756-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5156353-9934",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ID",
            "license": "ODP-100011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.