Individual provider Active NPI

Robert A Sorensen, O.D.

  • Optometrist
  • Hayden, ID
National Provider Identifier
1356335897
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-963 Issued in ID
Practice address
8445 N Government Way
Hayden, ID 83835-9280
Phone
(208) 772-3208
Fax
(208) 762-2574
NPI assigned
Sep 9, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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-963 ID Primary

Addresses

Primary practice location

8445 N Government Way
Hayden, ID 83835-9280

Mailing address

8445 N Government Way
Hayden, ID 83835-9280
Phone (208) 772-3208

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
I20100120000231 ID Practitioner - Optometry 9537200407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hayden Vision Source PLLCGroup PAC ID 6800282427, 5 clinicians

Practice addresses (Care Compare)

8445 N Government Way
Hayden, ID 83835-9349
Phone (208) 772-3208

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-963IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hayden Vision Center P.a. CurrentSince Jun 11, 1992 Accepting new patients
Hayden Vision Source PLLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Hayden Vision Center Optometrist Past Accepting new patients

Locations

8445 N Government Way
Hayden Lake, ID 83835
Phone (208) 762-0605

Organizations & group practices 3

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356335897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8445 N GOVERNMENT WAY",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359280",
            "telephone_number": "208-772-3208",
            "fax_number": "208-762-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 N GOVERNMENT WAY",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359280",
            "telephone_number": "208-772-3208",
            "fax_number": "208-762-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.