Brian J McKeon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

111111 Issued in ID

Practice address

1480 E Lincoln Rd
Idaho Falls, ID 83401-2128

Phone

(208) 525-8686

Fax

(208) 525-8684

NPI assigned

Jun 21, 2022

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

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, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Porter Eyecare PLLCGroup PAC ID 0345407656, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Porter Eyecare PLLC

  • Optometrist
  • Idaho Falls, ID
  • NPI 1770851446
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1841921863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012128",
            "telephone_number": "208-525-8686",
            "fax_number": "208-525-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012128",
            "telephone_number": "208-525-8686",
            "fax_number": "208-525-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "BRIAN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "111111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine E McInelly, M.ED.
• Brittany McIntosh
• Daniel James McIsaac, LCPC
• Brynlee McKague, MSN-FNPBC
• Gary McKell, LCSW
• Daniel William McLaughlin, M.D.
• Sarah McMann
• Amy Yaeger McManus, LCSW
• Emily Clare McMullin, RD
• Gabrielle Joy McMurphy, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.