NPIMap

Organization Active NPI

Vision Quest Medical Center, PA

  • Ophthalmology Physician
  • Caldwell, ID
National Provider Identifier
1497234306
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
O-0860 Issued in ID
Legal business name
VISION QUEST MEDICAL CENTER, PA
Practice address
1906 Fairview Ave Ste 100
Caldwell, ID 83605-5433
Phone
(208) 377-3937
Fax
(208) 377-9455
NPI assigned
Aug 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Authorized official

Name
Jacob Adam Mong, MDNPI 1346535481
Title
President
Phone
(208) 377-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X O-0860 ID Primary

Addresses

Primary practice location

1906 Fairview Ave Ste 100
Caldwell, ID 83605-5433

Mailing address

5680 W Gage St
Boise, ID 83706-1326
Phone (208) 377-3937

National Provider Directory

National Provider Directory
Tax ID family
Sonntag Eye Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5680 W Gage St
Boise, ID 83706
Phone (208) 377-3937

1906 Fairview Ave
Ste 100
Caldwell, ID 83605
Phone (208) 377-3937

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1497234306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061326",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 100",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055433",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION QUEST MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "MONG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-377-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "O-0860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.