St Maries Vision Center is a medicare enrolled "Optometrist" provider in St Maries, Idaho. Their current practice location is
704 W College Ave, St Maries, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 245-6563.
St Maries Vision Center is licensed to practice in Idaho (license number ODP1029) and it also participates in the medicare program. St Maries Vision Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1780190694.
Healthcare Provider's Profile
| Full Name | St Maries Vision Center |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 704 W College Ave, St Maries, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780190694
- Provider Enumeration Date: 12/15/2017
- Last Update Date: 12/15/2017
Medicare PECOS Information:
- PECOS PAC ID: 6608136957
- Enrollment ID: O20180205001925
Medical Identifiers
Medical identifiers for St Maries Vision Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780190694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | ODP1029 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
St Maries Vision Center acts as a billing entity for following providers:
| Provider Name | Lance W Fagan |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1891775151
PECOS PAC ID: 6305884917
Enrollment ID: I20050422000620 |
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| Provider Name | Robert John Johnson |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1265484604
PECOS PAC ID: 7416057856
Enrollment ID: I20070713000382 |
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| Provider Name | Jared Lambert |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1548944275
PECOS PAC ID: 0345695052
Enrollment ID: I20231016003238 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. St Maries Vision Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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St Maries Vision Center
704 W College Ave,
St Maries, ID 83861-1824
Ph: (208) 245-6563 | St Maries Vision Center
704 W College Ave,
St Maries, ID 83861-1824
Ph: (208) 245-6563 |
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