Landon Knight Hagberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

100220 Issued in ID

Practice address

10876 Mud Springs Ave.
Nampa, ID 83687-8013

Phone

(208) 757-2289

NPI assigned

Jul 9, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Eyecare Associates of Nampa PAGroup PAC ID 0244238004, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: referrals2@ecanampa.direct.kno2fy.com

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.

• Eyecare Associates of Nampa PA

  • Optometrist
  • Nampa, ID
  • NPI 1134204100
  Medicare reassignment Care Compare group NPD
• Mobilitycares LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1700440948
  Medicare reassignment NPD Authorized official
• Eyecare Associates of Kuna

  • Optometrist
  • Kuna, ID
  • NPI 1962067538
  Medicare reassignment NPD
• Mobilitycares Washington LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1184499741
  NPD (past) Authorized official
• Hollingshead Eye Center, PC

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1871643585

  Optometrist

  NPD (past)
• Mobilitycares Oregon LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1275308835
  NPD (past)
• Mobile Medical, Inc.

  • Podiatrist
  • Perrysburg, OH
  • NPI 1003066747
  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1699087437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10876 MUD SPRINGS AVE.",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836878013",
            "telephone_number": "208-757-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10876 MUD SPRINGS AVE.",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836878013",
            "telephone_number": "208-757-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGBERG",
        "first_name": "LANDON",
        "middle_name": "KNIGHT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100220",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699087437",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hachova, DNP
• Elizabeth Hachtel, LMSW
• Rachel Hackney
• J Kyle Hadley, PT, DPT
• Robert Edward Hadley, LMSW
• Jensen Renee Haigh, PT, DPT
• Kenneth M Hainsworth, M.D.
• Dori Lin Halbert, LCPC
• Halcyon Infusions & Therapeutics, PLLC
• Gillian Brooke Hall

• Optometrist in Nampa, ID
• Providers in Nampa, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.