Individual provider Active NPI

Kyle G Thompson, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Idaho Falls, ID
National Provider Identifier
1710111224
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
M12830 Issued in ID
Practice address
2100 Providence Way
Idaho Falls, ID 83404-6236
Phone
(208) 529-6600
Fax
(208) 529-6602
NPI assigned
May 12, 2009
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X M12830 ID Primary
Ophthalmology Physician 207W00000X M-12830 ID

Addresses

Primary practice location

2100 Providence Way
Idaho Falls, ID 83404-6236

Mailing address

2100 Providence Way
Idaho Falls, ID 83404-4951
Phone (208) 529-6600

Other identifiers 1

IdentifierTypeStateIssuer
1710111224MedicaidID

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150810002323 ID Practitioner - Ophthalmology 7810134111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Pennsylvania State University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Care of Eastern IdahoGroup PAC ID 2466611744, 11 clinicians

Practice addresses (Care Compare)

2100 Providence Way
Idaho Falls, ID 83404-4951
Phone (208) 529-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.96 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-12830IDMDOphthalmology Physician
M12830IDMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henrys Fork Surgery Center PLLC CurrentSince Oct 1, 2020 Accepting new patients
Retina and Vitreous Associates of Kentucky PLLC Ophthalmology CurrentSince Jul 8, 2013 Accepting new patients
Premier Eye Care of Eastern Idaho Ophthalmology CurrentSince Aug 17, 2015 Accepting new patients
Charles P. Lawless, M.D., P.a. Ophthalmology PastSince Jan 2, 1997 Accepting new patients

Locations

2100 Providence Way
Idaho Falls, ID 83404
Phone (208) 529-6600

1777 E Clark St
Ste 310
Pocatello, ID 83201
Phone (208) 232-4133

23 Sawtelle Ave
#101
Rexburg, ID 83440
Phone (208) 356-0070

23 Sawtelle Ave
#102
Rexburg, ID 83440
Phone (208) 359-1888

120 N Eagle Creek Dr
Ste 500
Lexington, KY 40509
Phone (859) 977-1129

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1710111224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044951",
            "telephone_number": "208-529-6600",
            "fax_number": "208-529-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046236",
            "telephone_number": "208-529-6600",
            "fax_number": "208-529-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KYLE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "ID",
            "license": "M12830",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M-12830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710111224",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.