Ada County Eyecare, P.C.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

ODP-900 Issued in ID

Legal business name

ADA COUNTY EYECARE, P.C.

Practice address

2069 E Feldspar CT
Boise, ID 83712-8456

Phone

(208) 869-1965

Fax

(208) 345-1137

NPI assigned

May 18, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven M. Polatis, O.D.NPI 1316294234

Title

President

Phone

(208) 869-1965

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Steven M Polatis, O.D.

  • Corneal and Contact Management Optometrist
  • Owyhee, NV
  • NPI 1316294234
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1619185485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2069 E FELDSPAR CT",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837128456",
            "telephone_number": "208-869-1965",
            "fax_number": "208-345-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2069 E FELDSPAR CT",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837128456",
            "telephone_number": "208-869-1965",
            "fax_number": "208-345-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA COUNTY EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "POLATIS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-869-1965",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ID",
            "license": "ODP-900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804046000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Corneal and Contact Management Optometrist in Boise, ID
• Providers in Boise, ID by specialty
• Corneal and Contact Management Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.