Individual provider Active NPI

Ryker Lane Meyer

  • Optometrist
  • Pocatello, ID
National Provider Identifier
1649063298
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7171668 Issued in ID
Practice address
4013 Yellowstone Ave Ste D
Pocatello, ID 83202-1984
Phone
(208) 417-1500
NPI assigned
May 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7171668 ID Primary

Addresses

Primary practice location

4013 Yellowstone Ave Ste D
Pocatello, ID 83202-1984

Mailing address

263 Ballard Rd
Pocatello, ID 83202-7007
Phone (208) 996-9479

Other practice location 1

2990 S 25th E
Idaho Falls, ID 83404-6515
Phone (208) 535-2604

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
I20250616001744 ID Practitioner - Optometry 0345751582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Eye Pros Idaho Falls LLCGroup PAC ID 6507184744, 3 clinicians
LWK P CGroup PAC ID 5890824247, 14 clinicians

Practice addresses (Care Compare)

2990 S 25TH
Idaho Falls, ID 83404-6515
Phone (833) 776-2020

4013 Yellowstone Ave
Suite D
Chubbuck, ID 83202-1984
Phone (208) 297-7019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Eye Pros Idaho Falls LLC Optometrist CurrentSince Jun 4, 2025 Accepting new patients
LWK, P.C. Optometrist CurrentSince Jun 4, 2025 Accepting new patients

Locations

291 N Milwaukee St
Ste A3
Boise, ID 83704
Phone (208) 297-7019

3485 N Cole Rd
Unit 45479
Boise, ID 83711

2990 S 25th E
Idaho Falls, ID 83404
Phone (208) 535-2600

4013 Yellowstone Ave
Ste D
Pocatello, ID 83202
Phone (208) 297-7019

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1649063298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 BALLARD RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832027007",
            "telephone_number": "208-996-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 YELLOWSTONE AVE STE D",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832021984",
            "telephone_number": "208-417-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2990 S 25th E",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834046515",
            "country_code": "US",
            "telephone_number": "208-535-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "RYKER",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "7171668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.