Individual provider Active NPI

Eric B Pierce, O.D.

  • Optometrist
  • Burley, ID
National Provider Identifier
1306107206
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100249 Issued in ID
Practice address
1970 Overland Ave
Burley, ID 83318-2439
Phone
(208) 678-3539
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100249 ID Primary

Addresses

Primary practice location

1970 Overland Ave
Burley, ID 83318-2439

Mailing address

1970 Overland Ave
Burley, ID 83318-2439
Phone (208) 678-3539

Other identifiers 1

IdentifierTypeStateIssuer
20001332OtherIDMEDICARE NUMBER

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
I20120830000364 ID Practitioner - Optometry 7618124439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burley Eye Care Center LLPGroup PAC ID 5294864294, 2 clinicians

Practice addresses (Care Compare)

1970 Overland Ave
Burley, ID 83318-2439
Phone (208) 678-3539

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100249IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Burley Eye Care Center, L.L.P. Optometrist CurrentSince Aug 1, 2012 Accepting new patients
Southern Idaho Ophthalmology PLLC Past Accepting new patients

Locations

1970 Overland Ave
Burley, ID 83318
Phone (208) 436-3455

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1306107206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182439",
            "telephone_number": "208-678-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182439",
            "telephone_number": "208-678-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "ERIC",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "20001332",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

Verify at the official NPI Registry.