Individual provider Active NPI

Terrence J Reynolds, O.D.

  • Optometrist
  • Boise, ID
National Provider Identifier
1386628162
Registry record updated Mar 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-807 Issued in ID
Practice address
6700 W Emerald St
Boise, ID 83704-8727
Phone
(208) 336-7100
Fax
(208) 321-2710
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 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-807 ID Primary

Addresses

Primary practice location

6700 W Emerald St
Boise, ID 83704-8727

Mailing address

6700 W Emerald St
Boise, ID 83704-8727
Phone (208) 336-7100

Other identifiers 1

IdentifierTypeStateIssuer
002692102MedicaidID

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
I20070313000610 ID Practitioner - Optometry 4981707841 Reassigns benefits to 1 organization
Practice locations: Mountain Home, ID; Boise, ID

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Eye Care PLLCGroup PAC ID 7113417452, 2 clinicians

Practice addresses (Care Compare)

265 N 3Rd
Mountain Home Eye Center
Mountain Home, ID 83647-2734
Phone (208) 587-8415

6700 W Emerald
Boise, ID 83704-8727

6700 W Emerald St
Boise, ID 83704-8727
Phone (208) 336-7100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-807IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Eye Care PLLC Optometrist CurrentSince Sep 1, 2006 Accepting new patients
Norris Eye Care LLC Optometrist PastSince Nov 25, 2014 Accepting new patients
JFK Vision PLLC Optometrist PastSince Dec 15, 2014 Accepting new patients

Locations

6700 W Emerald St
Boise, ID 83704
Phone (208) 336-7100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774051200000",
    "number": "1386628162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048727",
            "telephone_number": "208-336-7100",
            "fax_number": "208-321-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048727",
            "telephone_number": "208-336-7100",
            "fax_number": "208-321-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TERRENCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002692102",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.