Eyecare Associates of Eastgate PA

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

ODP-718 Issued in ID

Legal business name

EYECARE ASSOCIATES OF EASTGATE PA

Practice address

939 W. Beacon St
Boise, ID 83706-5118

Phone

(208) 344-8758

Fax

(208) 331-3379

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Winbigler

Title

Office Manager

Phone

(208) 344-8758

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 4

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

• Jacob Scott Shipton

  • Optometrist
  • Nampa, ID
  • NPI 1952977928

  ID

  Medicare reassignment Care Compare group NPD
• Janet L Collier, O.D.

  • Optometrist
  • Kirkwood, MO
  • NPI 1982606695

  ID

  Medicare reassignment Care Compare group NPD
• Todd Donald Winbigler, OD

  • Optometrist
  • Boise, ID
  • NPI 1760453435
  NPD
• Amber L Simonson, O.D.

  • Optometrist
  • Boise, ID
  • NPI 1386689156
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1265589048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W. BEACON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065118",
            "telephone_number": "208-344-8758",
            "fax_number": "208-331-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 W. BEACON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065118",
            "telephone_number": "208-344-8758",
            "fax_number": "208-331-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES OF EASTGATE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "WINBIGLER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-344-8758",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ID",
            "license": "ODP-718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002622500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V6622",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010015349",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew M Ewell, CRNA
• Maria K Ewings, MD
• Exodus Pain Clinic
• Explore Wellness, PLLC
• Eyecare Associates of Cole Village, P.a.
• Eyemart Express LLC
• Eyemart Express, LTD.
• Eyes of Idaho PC
• Carolyn Eyre
• Nikki A Eytchison

• All providers in Boise, ID
• Eyewear Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.