Individual provider Active NPI

Jaren Olsen, OD

  • Optometrist
  • Idaho Falls, ID
National Provider Identifier
1821597519
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100631 Issued in ID
Practice address
3508 S 25TH E
Idaho Falls, ID 83404-5027
Phone
(208) 557-3222
Fax
(208) 561-8692
NPI assigned
Feb 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X ODP-100631 ID
Optometrist 152W00000X ODP-100631 ID Primary

Addresses

Primary practice location

3508 S 25TH E
Idaho Falls, ID 83404-5027

Mailing address

3508 S 25TH E
Idaho Falls, ID 83404-5027
Phone (208) 557-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180314002558 WY Practitioner - Optometry 6204198039 Reassigns benefits to 1 organization
I20250106001829 ID Practitioner - Optometry 6204198039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3508 S 25TH
Idaho Falls, ID 83404-5027
Phone (208) 557-3222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100631IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Reframed Eye LLC Optometrist CurrentSince Nov 26, 2024 Accepting new patients
Wyovision Associates of Gillette LLC Optometrist CurrentSince Feb 27, 2018 Accepting new patients

Locations

3508 S 25th E
Idaho Falls, ID 83404
Phone (208) 557-3222

530 Running W Dr
#110
Gillette, WY 82718
Phone (307) 682-2747

Organizations & group practices 2

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": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726272000000",
    "number": "1821597519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 S 25TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045027",
            "telephone_number": "208-557-3222",
            "fax_number": "208-561-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 S 25TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045027",
            "telephone_number": "208-557-3222",
            "fax_number": "208-561-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JAREN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-07",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "ID",
            "license": "ODP-100631",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.