Individual provider Active NPI

Taylor Trent Webster, OD

  • Optometrist
  • Boise, ID
National Provider Identifier
1962071845
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100538 Issued in ID
Practice address
291 N Milwaukee St Ste a-3
Boise, ID 83704-9132
Phone
(833) 776-2020
Fax
(208) 297-7518
NPI assigned
Jun 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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-100538 ID Primary

Addresses

Primary practice location

291 N Milwaukee St Ste a-3
Boise, ID 83704-9132

Mailing address

3485 N Cole Rd Unit 45479
Boise, ID 83711-1095
Phone (833) 776-2020

Other practice location 1

16448 N Midland Blvd
Nampa, ID 83687-5222
Phone (833) 776-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@theeyepros.com

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
I20210802002557 ID Practitioner - Optometry 8729482583 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Midwestern University College of Dental Medicine, Glendale, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Associates PAGroup PAC ID 4789612441, 4 clinicians

Practice addresses (Care Compare)

2620 S Eagle Rd
Meridian, ID 83642-6704
Phone (208) 342-5151

Merit-based Incentive Payment System (MIPS)

Final score
90.16 of 100Reported as group
Quality
94
Improvement activities
40
Cost
75.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Associates, P.a. Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Eye Pros Treasure Valley Optometrist CurrentSince Feb 20, 2023 Accepting new patients
LWK, P.C. Optometrist CurrentSince Jul 2, 2021 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

1602 Arlington Ave
Caldwell, ID 83605
Phone (208) 459-0717

6252 N Linder Rd
Ste 150
Meridian, ID 83646
Phone (208) 297-7019

2620 S Eagle Rd
Meridian, ID 83642
Phone (208) 342-5151

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1962071845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 N COLE RD UNIT 45479",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837111095",
            "telephone_number": "833-776-2020",
            "fax_number": "208-297-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 N MILWAUKEE ST STE A-3",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049132",
            "telephone_number": "833-776-2020",
            "fax_number": "208-297-7518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16448 N Midland Blvd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836875222",
            "country_code": "US",
            "telephone_number": "833-776-2020",
            "fax_number": "208-297-7518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "TAYLOR",
        "middle_name": "TRENT",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@theeyepros.com",
            "affiliation": "N",
            "address_1": "291 N Milwaukee St Ste A-3",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837049132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.