Active NPI
Todd Donald Winbigler, OD
- Optometrist
- Boise, ID
National Provider Identifier
1760453435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP718
- Practice address
- 939 W. Beacon St
Boise, ID 83706 - Phone
- (208) 344-8758
- Fax
- (208) 331-3379
- NPI assigned
- Jan 30, 2006
- Last updated
- Mar 12, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP718 | ID | Primary |
Addresses
Primary practice location
939 W. Beacon St
Boise, ID 83706
Mailing address
939 W. Beacon St
Boise, ID 83706
Phone (208) 344-8758
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002622500 | Medicaid | ID | |
| 1243380001 | Other | ID | DMERC |
| 000010015349 | Other | ID | BLUE SHIELD |
| V6630 | Other | ID | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP718 | ID | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyecare Associates of Eastgate PA | Current | Accepting new patients |
Locations
939 W Beacon St
Boise, ID 83706
Phone (208) 344-8758
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Boise, ID
- NPI 1265589048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1760453435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "939 W. BEACON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "83706",
"telephone_number": "208-344-8758",
"fax_number": "208-331-3379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 W. BEACON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "83706",
"telephone_number": "208-344-8758",
"fax_number": "208-331-3379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINBIGLER",
"first_name": "TODD",
"middle_name": "DONALD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-30",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002622500",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "1243380001",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010015349",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "V6630",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.