Retina Specialists of Idaho Partners, PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

RETINA SPECIALISTS OF IDAHO PARTNERS, PLLC

Practice address

13923 W Wainwright Dr
Suite 301
Boise, ID 83713-1969

Phone

(208) 938-5624

Fax

(208) 938-5764

NPI assigned

Mar 26, 2014

Organization subpart

No

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

Authorized official

Name

Denton R. Roberts, MDNPI 1699742395

Title

Managing Partner

Phone

(208) 938-5624

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denton R Roberts, MD

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1699742395
  Medicare reassignment Care Compare group Authorized official
• James Benjamin Earl, MD PHD

  • Retina Specialist (Ophthalmology) Physician
  • Boise, ID
  • NPI 1720248305
  Medicare reassignment Care Compare group NPD
• Francois D Trotta, MD, PA

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1891731014
  Medicare reassignment NPD
• Daniel J Gealy, MD

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1538570817
  NPD
• Delores Marie Fischer, RN

  • Ophthalmic Registered Nurse
  • Boise, ID
  • NPI 1548299753
  NPD (past)

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1922425032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13923 W WAINWRIGHT DR",
            "address_2": "SUITE 301",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131969",
            "telephone_number": "208-938-5624",
            "fax_number": "208-938-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13923 W WAINWRIGHT DR",
            "address_2": "SUITE 301",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131969",
            "telephone_number": "208-938-5624",
            "fax_number": "208-938-5764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 E Mallard Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837063975",
            "country_code": "US",
            "telephone_number": "208-323-8660",
            "fax_number": "208-323-8686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA SPECIALISTS OF IDAHO PARTNERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "DENTON",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "208-938-5624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699742395",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denton.roberts.p1@direct.retinaidaho.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "13923 W Wainwright Dr",
            "address_2": "Suite 301",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837131969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Retina Specialist (Ophthalmology) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Retina Specialist (Ophthalmology) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.