| Matthew P Traynor, MD | |
|
2100 Providence Way, Idaho Falls, ID 83404 | |
| (208) 529-6600 | |
| (208) 529-6602 |
| Full Name | Matthew P Traynor |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 21 Years |
| Location | 2100 Providence Way, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063563823 | NPI | - | NPPES |
| 808405700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | M-10686 (Idaho) | Secondary |
| 207W00000X | Ophthalmology | 24632 (Oklahoma) | Secondary |
| 207WX0009X | Ophthalmology - Glaucoma Specialist | M-10686 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Eye Care Of Eastern Idaho | 2466611744 | 10 |
| Entity Name | Premier Eye Care Of Eastern Idaho |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790052603 PECOS PAC ID: 2466611744 Enrollment ID: O20120306000360 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew P Traynor, MD 2100 Providence Way, Idaho Falls, ID 83404-4951 Ph: (208) 529-6600 | Matthew P Traynor, MD 2100 Providence Way, Idaho Falls, ID 83404 Ph: (208) 529-6600 |
Dr. Kenneth W Turley, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 2025 E 17th St, Idaho Falls, ID 83404 Phone: 208-524-2025 Fax: 208-529-1924 | |
Dr. Gary Wayne Wallace, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2295 Coronado Street, Idaho Falls, ID 83404 Phone: 208-524-8600 Fax: 208-524-8394 | |
David Ray Anderson, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 530 S Holmes, Idaho Falls, ID 83403 Phone: 208-529-3937 Fax: 208-524-4380 | |
Dr. Bradley P Gardner, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2025 E 17th St, Idaho Falls, ID 83404 Phone: 208-524-2025 Fax: 208-529-1924 | |
Dr. Spencer James Harris, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2025 E 17th St, Idaho Falls, ID 83404 Phone: 208-524-2025 Fax: 208-524-2025 | |
Mr. Peter Carl Zimmerman, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1449 E 17th Street, Idaho Falls, ID 83404 Phone: 208-529-6600 Fax: 208-529-6603 |