Individual provider Active NPI

Nash Van Klompenburg, OD

  • Optometrist
  • Nampa, ID
National Provider Identifier
1477446607
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6271263 Issued in ID
Practice address
901 12TH Ave S
Nampa, ID 83651-4658
Phone
(208) 466-9251
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6271263 ID Primary

Addresses

Primary practice location

901 12TH Ave S
Nampa, ID 83651-4658

Mailing address

1871 Spanish Fork Way
Meridian, ID 83642-5595
Phone (320) 212-7052

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
I20250917000036 ID Practitioner - Optometry 4183128804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel L Tiller PAGroup PAC ID 3476633801, 4 clinicians

Practice addresses (Care Compare)

901 12TH S Ave
Nampa, ID 83651-4658
Phone (208) 466-9251

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6271263IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel L Tiller PA Optometrist CurrentSince Jun 20, 2025 Accepting new patients

Locations

901 12th Ave S
Nampa, ID 83651
Phone (208) 466-9251

Organizations & group practices 1

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1477446607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 SPANISH FORK WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425595",
            "telephone_number": "320-212-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 12TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514658",
            "telephone_number": "208-466-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KLOMPENBURG",
        "first_name": "NASH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "6271263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.