Kenneth M Hainsworth, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

M8605 Issued in ID

Practice address

215 E Hawaii Ave Ste 260
Nampa, ID 83686-6011

Phone

(208) 593-7199

Fax

(208) 593-7195

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Kentucky College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canyon Eyecare PLLCGroup PAC ID 8820530157, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Valley Medical Center Hospital, Caldwell, ID, CCN 130014
• St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADDEDD
• FHIR API: https://fhir4.healow.com/fhir/r4/ADHBAA

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.

• Canyon Eyecare PLLC

  • Ophthalmology Physician
  • Nampa, ID
  • NPI 1376302372

  ID, Ophthalmology

  Medicare reassignment Care Compare group NPD Authorized official
• Saltzer Medical Group, PA

  • Family Medicine Physician
  • Nampa, ID
  • NPI 1376574442

  Ophthalmology

  NPD
• Southern Idaho Health Partners LLC

  • General Practice Physician
  • Meridian, ID
  • NPI 1952701401
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes West LTD

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660

  Hospital

  Care Compare affiliation
• West Valley Medical Center Inc

  • General Acute Care Hospital
  • Middleton, ID
  • NPI 1609818483

  Hospital

  Care Compare affiliation
• West Valley Medical Center, Inc.

  • General Acute Care Hospital
  • Caldwell, ID
  • NPI 1891732905

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1942290929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE STE 260",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-593-7199",
            "fax_number": "208-593-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE STE 260",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-593-7199",
            "fax_number": "208-593-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINSWORTH",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M8605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806365500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "48801",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J6576",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010138766",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180044930",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010138765",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenhainsworth@canyoneyedocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "215 E Hawaii Ave Ste 260",
            "city": "Nampa",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836866011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Hackney
• J Kyle Hadley, PT, DPT
• Robert Edward Hadley, LMSW
• Landon Knight Hagberg, O.D.
• Jensen Renee Haigh, PT, DPT
• Dori Lin Halbert, LCPC
• Halcyon Infusions & Therapeutics, PLLC
• Gillian Brooke Hall
• Jody Hall
• Muzdalifa Hamad

• All providers in Nampa, ID
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.