| Ada Vision Center P.a. | |
|
1333 W Jefferson St, Boise, ID 83702-5320 | |
| (208) 336-2020 | |
| (208) 384-5677 |
| Full Name | Ada Vision Center P.a. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1333 W Jefferson St, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407869589 | NPI | - | NPPES |
| U80987 | Medicaid | ID | |
| 000010138576 | Other | ID | REGENCE BLUE SHIELD |
| V7042 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Amber L Simonson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386689156 PECOS PAC ID: 5496777187 Enrollment ID: I20051221001021 |
| Provider Name | Todd Anthony Noble |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548268931 PECOS PAC ID: 7810895976 Enrollment ID: I20110317000187 |
| Provider Name | Lauren M Huber |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942563424 PECOS PAC ID: 2466600473 Enrollment ID: I20120917000863 |
| Provider Name | Russell Lamar Gray |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023678778 PECOS PAC ID: 6507195559 Enrollment ID: I20190917001520 |
| Provider Name | Amanda Moore-elcyzyn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780612499 PECOS PAC ID: 8224033352 Enrollment ID: I20200902003571 |
| Provider Name | Erin Rolfes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003344375 PECOS PAC ID: 0840561387 Enrollment ID: I20211005002012 |
| Provider Name | Ryan Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164849964 PECOS PAC ID: 3971815390 Enrollment ID: I20220202001872 |
| Provider Name | Christina Danley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821297896 PECOS PAC ID: 0143302174 Enrollment ID: I20221219002512 |
| Provider Name | Tobin Hale |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467973529 PECOS PAC ID: 5597030767 Enrollment ID: I20230130001057 |
| Provider Name | David Harsini |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215414289 PECOS PAC ID: 6901234889 Enrollment ID: I20240702002651 |
| Mailing Address | Practice Location Address |
|---|---|
| Ada Vision Center P.a. 1333 W Jefferson St, Boise, ID 83702-5320 Ph: (208) 336-2020 | Ada Vision Center P.a. 1333 W Jefferson St, Boise, ID 83702-5320 Ph: (208) 336-2020 |
Vision Quest Medical Center, Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5680 W Gage St, Boise, ID 83706 Phone: 208-377-3937 Fax: 208-377-9455 | |
Dr. Gregory N Bodily, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 610 Americana Blvd, Boise, ID 83702 Phone: 208-344-2020 Fax: 208-344-2371 | |
Brent Sexauer, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1175 W Boise Ave, Boise, ID 83706 Phone: 208-384-9194 | |
J. Randall Pitman & Associates, P.c. Optometrist Medicare: Medicare Enrolled Practice Location: 2051 S Cole Rd, Boise, ID 83709 Phone: 208-672-1200 Fax: 208-321-8728 | |
Dr. James W Vail, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3417 N Cole Rd, Boise, ID 83704 Phone: 208-377-1102 Fax: 208-377-5853 | |
Dr. Lavar W Kofoed, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 291 N Milwaukee St, Boise, ID 83704 Phone: 208-378-7020 Fax: 208-378-9460 | |
Dr. Paul Christian Neville, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 305 E Jefferson St, Boise, ID 83712 Phone: 208-381-6910 |