Idaho Eyelid & Facial Plastic Surgery , Pllc is a medicare enrolled "Ophthalmology" provider in Boise, Idaho. Their current practice location is
111 W Main St Ste 200, Boise, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 344-3220.
Idaho Eyelid & Facial Plastic Surgery , Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Idaho Eyelid & Facial Plastic Surgery , Pllc
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 1255401436.
Healthcare Provider's Profile
| Full Name | Idaho Eyelid & Facial Plastic Surgery , Pllc |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 111 W Main St Ste 200, Boise, 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: 1255401436
- Provider Enumeration Date: 11/08/2006
- Last Update Date: 04/03/2020
Medicare PECOS Information:
- PECOS PAC ID: 3375457906
- Enrollment ID: O20050405000613
Medical Identifiers
Medical identifiers for Idaho Eyelid & Facial Plastic Surgery , Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255401436 | NPI | - | NPPES |
| 8F488 | Other | ID | BLUE CROSS OF IDAHO |
| 000010027884 | Other | ID | REGENCE BLUE SHIELD |
| CJ6700 | Other | ID | MEDICARE RR |
| 806295400 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Idaho Eyelid & Facial Plastic Surgery , Pllc acts as a billing entity for following providers:
| Provider Name | Mark J Boerner |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1003819459
PECOS PAC ID: 6901710540
Enrollment ID: I20100507000037 |
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| Provider Name | Chad Harman Jackson |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1184067498
PECOS PAC ID: 2567754872
Enrollment ID: I20200804000870 |
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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. Idaho Eyelid & Facial Plastic Surgery , Pllc 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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Idaho Eyelid & Facial Plastic Surgery , Pllc
111 W Main St Ste 200,
Boise, ID 83702-7308
Ph: (208) 344-3220 | Idaho Eyelid & Facial Plastic Surgery , Pllc
111 W Main St Ste 200,
Boise, ID 83702-7308
Ph: (208) 344-3220 |
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