Steven G Iwasa OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODD649 Issued in ID

Legal business name

STEVEN G IWASA OD PLLC

Practice address

36 W Court St
Weiser, ID 83672-1941

Phone

(208) 414-1600

Fax

(208) 414-1607

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Steven G Iwasa, ODNPI 1003985466

Title

Optometrist

Phone

(208) 414-1600

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Weiser Vision Clinic Doing business as

Locations

Practitioners 1

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

• Steven G Iwasa, O.D.

  • Optometrist
  • Weiser, ID
  • NPI 1003985466
  NPD (past) Authorized official

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1184994147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W COURT ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836721941",
            "telephone_number": "208-414-1600",
            "fax_number": "208-414-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W COURT ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836721941",
            "telephone_number": "208-414-1600",
            "fax_number": "208-414-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN G IWASA OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "IWASA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "208-414-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODD649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008449",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "814368000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00102776",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V4999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010137310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weiser Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.