Individual provider Active NPI

Brandon Bennett Crawford, O.D.

  • Optometrist
  • Meridian, ID
National Provider Identifier
1912159823
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100179 Issued in ID
Practice address
4051 E Fairview Ave
Meridian, ID 83642
Phone
(208) 373-7926
Fax
(208) 373-7928
NPI assigned
Oct 22, 2008
Last updated
Feb 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100179 ID Primary

Addresses

Primary practice location

4051 E Fairview Ave
Meridian, ID 83642

Mailing address

4051 E Fairview Ave
Meridian, ID 83642
Phone (208) 373-7926

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
I20090605000595 ID Practitioner - Optometry 0941350391 Reassigns benefits to 1 organization
Practice locations: Meridian, ID

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Quality
77.91
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Eye Care, LLC Optometrist Current Accepting new patients
LWK, P.C. Optometrist CurrentSince May 30, 2023 Accepting new patients
Crawford Eye Care, LLC Optometrist PastSince Mar 4, 2014 Accepting new patients

Locations

291 N Milwaukee St
Ste A3
Boise, ID 83704
Phone (208) 297-7019

3485 N Cole Rd
Unit 45479
Boise, ID 83711

4051 E Fairview Ave
Meridian, ID 83642
Phone (208) 373-0024

16448 N Midland Blvd
Nampa, ID 83687
Phone (208) 467-7020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1912159823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 E FAIRVIEW AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-373-7926",
            "fax_number": "208-373-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 E FAIRVIEW AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-373-7926",
            "fax_number": "208-373-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "BRANDON",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.