Chad William Cleverly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-1015 Issued in ID

Practice address

3293 N Milwaukee St
Boise, ID 83704-4446

Phone

(208) 322-2020

Fax

(208) 322-1192

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boise Vision Care, P.a.Group PAC ID 4284768656, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Boise Vision Care, P.a.

  • Optometrist
  • Boise, ID
  • NPI 1134295116
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386660959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3293 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-322-2020",
            "fax_number": "208-322-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3293 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-322-2020",
            "fax_number": "208-322-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVERLY",
        "first_name": "CHAD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-1015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010015598",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA SUPPLIER",
            "identifier": "0198230001",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V3967",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Lysette Clemens
• Emily Alings Clements, LPC
• Steven Don Clements, O.D.
• Timothy Cleveland
• Kristin Cleverdon, PHARMD
• Kathleen Clifford, NP
• Kevin A Clifford, MD
• Joseph J Clift, CRNA
• Peter Matthew Cliften, M.D.
• Meloney Clifton, L.M.T.

• Optometrist in Boise, ID
• Providers in Boise, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.