Individual provider Active NPI

James Russell Bewley, OD

  • Optometrist
  • Caldwell, ID
National Provider Identifier
1639257017
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP 100085 Issued in ID
Practice address
420 E Elm Street
Caldwell, ID 83605-4846
Phone
(208) 459-2020
Fax
(208) 459-2034
NPI assigned
Nov 1, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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 100085 ID Primary

Addresses

Primary practice location

420 E Elm Street
Caldwell, ID 83605-4846

Mailing address

420 E Elm Street
Caldwell, ID 83605-4846
Phone (208) 459-2020

Other identifiers 1

IdentifierTypeStateIssuer
807263100MedicaidID

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
I20080605000276 ID Practitioner - Optometry 9436229200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Quest Medical Center PAGroup PAC ID 0547528598, 6 clinicians

Practice addresses (Care Compare)

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

Merit-based Incentive Payment System (MIPS)

Final score
92.92 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP 100085IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare Specialists PLLC Optometrist CurrentSince Jan 10, 2006 Accepting new patients
Vision Quest Medical Center, PA Optometrist CurrentSince May 1, 2024 Accepting new patients
Family Eyecare Specialists PLLC Optometrist PastSince Dec 7, 2025 Accepting new patients
Insight Optical Optometrist PastSince Jan 10, 2006 Accepting new patients

Locations

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

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

420 E Elm St
Caldwell, ID 83605
Phone (208) 459-2020

3025 W Cherry Ln
Ste 207
Meridian, ID 83642
Phone (208) 377-3937

2720 W Cherry Ln
Meridian, ID 83642
Phone (208) 377-3937

4424 E Flamingo Ave
Ste 100
Nampa, ID 83687
Phone 2084592020309

Interoperability endpoints

  • FHIR API: https://familyeyes.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1639257017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E ELM STREET",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-2020",
            "fax_number": "208-459-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E ELM STREET",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-2020",
            "fax_number": "208-459-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEWLEY",
        "first_name": "JAMES",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP 100085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807263100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.