Individual provider Active NPI

Brian J McNeel, O.D.

  • Optometrist
  • Boise, ID
National Provider Identifier
1821094152
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP933 Issued in ID
Practice address
360 E Mallard Dr
Ste 110
Boise, ID 83706-3945
Phone
(208) 336-8700
Fax
(208) 426-0902
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP933 ID Primary

Addresses

Primary practice location

360 E Mallard Dr
Ste 110
Boise, ID 83706-3945

Mailing address

13900 W Wainwright Dr
Suite 101
Boise, ID 83713-5028
Phone (208) 938-2010

Other identifiers 1

IdentifierTypeStateIssuer
0043208MedicaidID

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000355 ID Practitioner - Optometry 7113096330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McNeel Eye Center IncGroup PAC ID 5294804415, 4 clinicians

Practice addresses (Care Compare)

4270 N Eagle Rd
Boise, ID 83713-0726
Phone (208) 938-2010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP933IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
McNeel Eye Center, Inc. Optometrist CurrentSince Apr 25, 2008 Accepting new patients

Locations

13900 W Wainwright Dr
Ste 101
Boise, ID 83713
Phone (208) 938-2010

4270 N Eagle Rd
Boise, ID 83713
Phone (208) 938-2010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1821094152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 W WAINWRIGHT DR",
            "address_2": "SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135028",
            "telephone_number": "208-938-2010",
            "fax_number": "208-938-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E MALLARD DR",
            "address_2": "STE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063945",
            "telephone_number": "208-336-8700",
            "fax_number": "208-426-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEEL",
        "first_name": "BRIAN",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043208",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.