Verlyn Dean Broek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-542 Issued in ID

Practice address

215 4TH Ave N
Twin Falls, ID 83301-6139

Phone

(208) 734-5100

Fax

(208) 734-5134

NPI assigned

Nov 29, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 2

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

University of Houston - College of Optometry, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr Verlyn Broek

  • Optometrist
  • Twin Falls, ID
  • NPI 1457538605
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760559223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 4TH AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016139",
            "telephone_number": "208-734-5100",
            "fax_number": "208-734-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 4TH AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016139",
            "telephone_number": "208-734-5100",
            "fax_number": "208-734-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEK",
        "first_name": "VERLYN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010015324",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V5020",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Jensen Optometry, LLC
• Brian Tingey DDS LLC
• Carrie Bridges
• Corey Bridges, LCPC
• Bridgeview Medical Investors, LLC (Bridge View Estates)
• Brookdale Senior Living Communities, Inc. (Brookdale Twin Falls)
• Kari L Brose, PA
• Dillon Brower, DPT
• Brown and Bradshaw Physical Therapy
• Aaron B Brown, MD

• Optometrist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.