Brent Anthony Galvan, O.D.
Individual provider Active NPI Corneal and Contact Management Optometrist · Boise, ID
NPI 1285759753 · NPPES record last updated Dec 31, 2013
Key facts
- NPI
- 1285759753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Corneal and Contact Management Optometrist 152WC0802X
- License
- ODP100-177 (ID)
- Practice address
- 8102 W Northview St
Boise, ID 83704-4406 - Phone
- (208) 377-1102
- Fax
- (208) 377-5853
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8102 W Northview St
Boise, ID 83704-5096
Phone (208) 377-1102
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110808000392 | ID | Practitioner - Optometry | 3274566708 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP100-177 | ID | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cole Family Eye Center, PA | Corneal and Contact Management | Current |
Accepting new patients |
| Mark a Galvan | Past | Accepting new patients |
Locations
8102 W Northview St
Boise, ID 83704
Phone (208) 377-1102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | ODP100-177 | ID | Yes |
Addresses
Primary practice location
8102 W Northview St
Boise, ID 83704-4406
Mailing address
8102 W Northview St
Boise, ID 83704-4406
Phone (208) 377-1102
Other providers in Boise, ID
- Laura Lynn Gallo
- Gregory C Galloway
- Meghan M Galloway
- Trent Galloway
- Heather Galm
- Olivia Ann Galvez
- Melodie Karol Galyen
- Jessica Nicole Gambill
- Melanie Ellen Gambill
- Belinda Estolia Gamboa
All providers in Boise, ID · Corneal and Contact Management Optometrist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.