Individual provider Active NPI

Hayden Alexander Thieme, OD

  • Optometrist
  • Meridian, ID
National Provider Identifier
1841065257
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
100643 Issued in ID
Practice address
1648 NW 2ND St
Meridian, ID 83642-2224
Phone
(208) 888-2200
NPI assigned
Nov 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 100643 ID Primary

Addresses

Primary practice location

1648 NW 2ND St
Meridian, ID 83642-2224

Mailing address

1191 W Laughton Dr
Meridian, ID 83646-6542

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
I20231207003319 ID Practitioner - Optometry 9739538349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dan C Thieme OD PCGroup PAC ID 3173507399, 2 clinicians

Practice addresses (Care Compare)

1648 NW 2ND St
Meridian, ID 83642-2224
Phone (208) 888-2200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100643IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dan C. Thieme O.D., P.C Optometrist CurrentSince Nov 28, 2023 Accepting new patients
Dan C Thieme OD PC Optometrist PastSince Nov 19, 2023 Accepting new patients

Locations

1648 NW 2nd St
Meridian, ID 83642
Phone (208) 888-2200

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": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1841065257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 W LAUGHTON DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 NW 2ND ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422224",
            "telephone_number": "208-888-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEME",
        "first_name": "HAYDEN",
        "middle_name": "ALEXANDER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.