Individual provider Active NPI

Amber L Simonson, O.D.

  • Optometrist
  • Boise, ID
National Provider Identifier
1386689156
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP 1017 Issued in ID
Practice address
1926 W State St
Boise, ID 83702-3957
Phone
(208) 336-2020
NPI assigned
Jun 17, 2006
Last updated
Jun 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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 1017 ID Primary

Addresses

Primary practice location

1926 W State St
Boise, ID 83702-3957

Mailing address

1926 West Jefferson Street
Boise, ID 83702
Phone (208) 336-2020

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
I20051221001021 ID Practitioner - Optometry 5496777187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams Eyecare IncGroup PAC ID 5991940850, 2 clinicians

Practice addresses (Care Compare)

3541 W Bavaria St
Eagle, ID 83616-6318
Phone (208) 939-5005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP 1017IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Adams Eyecare Inc Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Ada Vision Center P.a. Optometrist CurrentSince Feb 1, 2007 Accepting new patients
Eyecare Associates of Eastgate PA PastSince Nov 10, 1999 Accepting new patients
Vision One McCall Inc Optometrist Past Accepting new patients
Vision One Inc Optometrist PastSince Apr 12, 2001 Accepting new patients

Locations

1926 W State St
Boise, ID 83702
Phone (208) 336-2020

3541 W Bavaria St
Eagle, ID 83616
Phone (208) 939-5005

2103 N Cassia St
Nampa, ID 83651
Phone (208) 465-0088

Organizations & group practices 5

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1386689156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 WEST JEFFERSON STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-336-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023957",
            "telephone_number": "208-336-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "AMBER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP 1017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.