Individual provider Active NPI

Golden Thaddeus Buckland III, M.D.

  • Ophthalmology Physician
  • Coeur D Alene, ID
National Provider Identifier
1942402904
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M9945 Issued in ID
Practice address
1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone
(208) 667-2531
Fax
(208) 765-9385
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M9945 ID Primary

Addresses

Primary practice location

1814 Lincoln Way
Coeur D Alene, ID 83814-2540

Mailing address

1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone (208) 667-2531

Other practice location 1

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000

Other identifiers 5

IdentifierTypeStateIssuer
000010162794OtherBLUE SHIELD
1518003516OtherNORTH IDAHO CATARACT & LA
807806900MedicaidID
1100054OtherMEDICARE
76960OtherBLUE CROSS OF IDAHO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbuckland627468@direct.multicare.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070922000136 ID Practitioner - Ophthalmology 8729172697 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Boston University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Idaho Eye Institute P aGroup PAC ID 8820182736, 11 clinicians

Practice addresses (Care Compare)

1814 Lincoln Way
Coeur D Alene, ID 83814-2540
Phone (208) 667-2531

1901 E Seltice Way
Post Falls, ID 83854-9647
Phone (208) 667-2531

8378 N Government Way
Hayden, ID 83835-9258
Phone (208) 667-2531

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery296

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9945IDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Eye Institute P a Ophthalmology CurrentSince Sep 1, 2007 Accepting new patients
Kootenai Health, Inc. CurrentSince Dec 31, 2017 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Dec 31, 2017 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
North Idaho Cataract & Laser Ctr Past Accepting new patients

Locations

1814 Lincoln Way
Coeur D Alene, ID 83814
Phone (208) 667-2531

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

8378 N Government Way
Hayden, ID 83835
Phone (208) 209-7100

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

1901 E Seltice Way
Post Falls, ID 83854
Phone (208) 667-2531

1110 E Polston Ave
Post Falls, ID 83854
Phone (208) 773-1180

Organizations & group practices 6

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 1

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1942402904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142540",
            "telephone_number": "208-667-2531",
            "fax_number": "208-765-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142540",
            "telephone_number": "208-667-2531",
            "fax_number": "208-765-9385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLAND",
        "first_name": "GOLDEN",
        "middle_name": "THADDEUS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M9945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010162794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH IDAHO CATARACT & LA",
            "identifier": "1518003516",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807806900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1100054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "76960",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbuckland627468@direct.multicare.org",
            "affiliation": "N",
            "address_1": "2003 Kootenai Health Way",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838146051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.