NPIMap

Individual provider Active NPI

Alan Wallace McInnes Jr., M.D.

  • Ophthalmology Physician
  • Eagle, ID
National Provider Identifier
1942345228
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M11139 Issued in ID
Practice address
323 E Riverside Dr, Suite 136
Eagle
Eagle, ID 83616-6865
Phone
(208) 939-2939
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A98662 CA
Ophthalmology Physician 207W00000X 5755878-1205 UT
Ophthalmology Physician 207W00000X M11139 ID Primary

Addresses

Primary practice location

323 E Riverside Dr, Suite 136
Eagle
Eagle, ID 83616-6865

Mailing address

323 E Riverside Dr, Suite 136
Eagle, ID 83616-6865
Phone (208) 939-2939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000381 ID Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 8628159332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
University of Utah School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3357 W Bavaria St
Eagle, ID 83616-5341
Phone (208) 939-2939

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.23 of 100Reported as individual
Quality
80.45
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A98662CAMDOphthalmology Physician
M11139IDMDOphthalmology Physician
5755878-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Eye PC CurrentSince Nov 28, 2011 Accepting new patients
Eyesthetica PastSince Jun 26, 2022 Accepting new patients

Locations

323 E Riverside Dr
Ste 136
Eagle, ID 83616
Phone (208) 939-2939

3357 W Bavaria St
Eagle, ID 83616
Phone (208) 939-2939

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1942345228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E RIVERSIDE DR, SUITE 136",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166865",
            "telephone_number": "208-939-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E RIVERSIDE DR, SUITE 136",
            "address_2": "EAGLE",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166865",
            "telephone_number": "208-939-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNES",
        "first_name": "ALAN",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A98662",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "5755878-1205",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.