Carolee Marie Cutler Peck, M.D., M.P.H.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

M-15305 Issued in ID

Practice address

3365 Chasewood Drive
Ammon, ID 83406

Phone

(208) 228-5555

Fax

(208) 228-0077

NPI assigned

May 20, 2009

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Utah School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolee M Cutler Peck MD MPH Oprs PLLC

  dba Cutler Peck Oculofacial Plastic Surgery

  • Medical Specialty Clinic/Center
  • Ammon, ID
  • NPI 1821741323

  Single Specialty

  Medicare reassignment NPD Authorized official
• Ma Bo Inc

  dba House Call Doctors

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1740461219

  Single Specialty

  Medicare reassignment NPD
• Ma Bo Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1588185581

  Single Specialty

  NPD
• Idaho Neurosurgical Center, PA

  • Neurological Surgery Physician
  • Idaho Falls, ID
  • NPI 1477798148

  Single Specialty

  NPD (past)
• Southeast Eye Specialists, PLLC

  • Ophthalmology Physician
  • Soddy Daisy, TN
  • NPI 1750981189
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1588899488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50678",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834050678",
            "telephone_number": "208-228-5555",
            "fax_number": "208-228-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 CHASEWOOD DRIVE",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-228-5555",
            "fax_number": "208-228-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTLER PECK",
        "first_name": "CAROLEE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "ID",
            "license": "M-15305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taresa Dawn Crow
• Cureton Counseling, LLC
• Dawn Marie Cureton, PSYD
• Tarmigan Cushing
• Michael Cuthbertson, D.P.T.
• Courtnie Cutler
• Christopher Dahle, DPT
• Tanna Jane Dalling, RESPITE
• Cassie Davis
• Clarence Davis, LSW

• Ophthalmic Plastic and Reconstructive Surgery Physician in Ammon, ID
• Providers in Ammon, ID by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.