Bonneville Vision, PLLC
NPI 1093367971ActiveOrganization· Optometrist· Idaho Falls, ID
Optometrist in Idaho Falls, Idaho, registered in NPPES in July 2019. The authorized official on file is Nathan Housley, OD, Managing Member. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1093367971 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 11, 2019 |
| Last updated in NPPES | Jul 11, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (ID); Part B Supplier - Clinic/Group Practice (ID) |
|---|
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