Individual provider Active NPI

Jason Scott Ritter

  • Optometrist
  • Lewiston, ID
National Provider Identifier
1588071633
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100316 Issued in ID
Practice address
939 Bryden Ave
Lewiston, ID 83501-5057
Phone
(208) 743-1761
NPI assigned
Jul 21, 2014
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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-100316 ID Primary

Addresses

Primary practice location

939 Bryden Ave
Lewiston, ID 83501-5057

Mailing address

939 Bryden Ave
Lewiston, ID 83501-5057
Phone (208) 743-1761

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
I20141110000293 ID Practitioner - Optometry 9537381439 Receives reassigned benefits from 2 practitioners
Practice locations: Lewiston, ID

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

939 Bryden Ave
Lewiston, ID 83501-5057
Phone (208) 743-1761

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100316IDMDOptometrist

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, 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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1588071633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 BRYDEN AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015057",
            "telephone_number": "208-743-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 BRYDEN AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015057",
            "telephone_number": "208-743-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITTER",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.