NPIMap

Organization Active NPI

North Idaho Eye Institute P a

Doing business as Coeur D Alene Eye Clinic Post Falls Eye Clinic

  • Ophthalmology Physician
  • Coeur d'Alene, ID
National Provider Identifier
1699811646
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTH IDAHO EYE INSTITUTE P A
Doing business as
Coeur D Alene Eye Clinic Post Falls Eye Clinic
Practice address
1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone
(208) 667-2531
Fax
(208) 765-9385
NPI assigned
Jan 29, 2007
Last updated
Apr 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Authorized official

Name
Ms. Alysse Craner
Title
Practice Administrator
Phone
(208) 667-2531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1814 Lincoln Way
Coeur D Alene, ID 83814-2540

Mailing address

1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone (208) 667-2531

Other identifiers 2

IdentifierTypeStateIssuer
0023705MedicaidID
000010018019OtherIDREGENCE BLUE SHIELD OF ID

Other names 1

  • Coeur D Alene Eye Clinic Post Falls Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070924000239 ID Part B Supplier - Clinic/Group Practice 8820182736 Receives reassigned benefits from 11 practitioners
Practice locations: Coeur D Alene, ID; Hayden, ID; Ponderay, ID; Post Falls, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2287459North Idaho Eye Institute1814 Lincoln Way Upper Level, Coeur D'Alene, ID 83814Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

30544 Highway 200
Ste 309
Ponderay, ID 83852
Phone (208) 667-2531

1110 E Polston Ave
Post Falls, ID 83854
Phone (208) 773-1180

1901 E Seltice Way
Post Falls, ID 83854
Phone (208) 667-2531

Interoperability endpoints

  • Direct secure messaging: aheaton@northidahoeye.intellechartdirect.net
  • Direct secure messaging: dtosland@northidahoeye.intellechartdirect.net
  • Direct secure messaging: kgleason@northidahoeye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1699811646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142540",
            "telephone_number": "208-667-2531",
            "fax_number": "208-765-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142540",
            "telephone_number": "208-667-2531",
            "fax_number": "208-765-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO EYE INSTITUTE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "CRANER",
        "authorized_official_first_name": "ALYSSE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "208-667-2531",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023705",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010018019",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coeur D Alene Eye Clinic Post Falls Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coeur D Alene Eye Clinic Post Falls Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.