Organization Active NPI

Jensen Eye Associates PLLC

  • Ophthalmology Physician
  • Nampa, ID
National Provider Identifier
1871548669
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JENSEN EYE ASSOCIATES PLLC
Practice address
1615 12TH Ave Rd
Ste a
Nampa, ID 83686-7713
Phone
(208) 467-3271
Fax
(208) 467-4450
NPI assigned
May 23, 2006
Last updated
Aug 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Authorized official

Name
Peter E Jensen, M.D.
Title
Owner
Phone
(208) 467-3271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1615 12TH Ave Rd
Ste a
Nampa, ID 83686-7713

Mailing address

1615 12TH Ave Rd
Ste a
Nampa, ID 83686-6184
Phone (208) 467-3271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060525000232 ID Part B Supplier - Clinic/Group Practice 7113938457 Receives reassigned benefits from 5 practitioners
Practice locations: Nampa, ID
O20100930031638 ID DME Supplier - Physician - General Practice 7113938457 Practice locations: Nampa, ID

National Provider Directory

National Provider Directory

Locations

1603 12th Ave Rd
Nampa, ID 83686
Phone (208) 442-0096

1615 12th Ave Rd
Nampa, ID 83686

1615 12th Ave Rd
Ste A
Nampa, ID 83686
Phone (208) 467-3271

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1871548669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 12TH AVE RD",
            "address_2": "STE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866184",
            "telephone_number": "208-467-3271",
            "fax_number": "208-467-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 12TH AVE RD",
            "address_2": "STE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836867713",
            "telephone_number": "208-467-3271",
            "fax_number": "208-467-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENSEN EYE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-467-3271",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.