Vitaliy Pelikhatyy, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

100541 Issued in ID

Practice address

8359 W Emerald St
Boise, ID 83704-8304

Phone

(208) 321-0901

NPI assigned

Oct 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oic Eye Care LLC

  • Optometrist
  • Boise, ID
  • NPI 1699444794
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1740515824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8359 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048304",
            "telephone_number": "360-721-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048304",
            "telephone_number": "208-321-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELIKHATYY",
        "first_name": "VITALIY",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariane Diola Pedida
• Peer Recovery Supports of Idaho
• Weston Peine, DO
• Alyssa Pekas, MS
• Rico Lynn Pelazini, PHARM D, RPH
• Angela Dawn Pellant, MD
• Catherine R Pellizzari, LCSW
• Janet McReynolds Pelton, FNP
• Michael Pelton, M.D.
• Mary Pena-Ynda

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.