Eyedaho Optometric LLC
NPI 1417627480ActiveOrganization· Optometrist· Idaho Falls, ID
Optometrist in Idaho Falls, Idaho, registered in NPPES in September 2021. The authorized official on file is Trevor Dickson, OD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417627480 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2021 |
| Last updated in NPPES | Sep 20, 2021 |
| Certified by provider | Sep 2, 2021 |
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 Part B Supplier - Clinic/Group Practice (ID) |
|---|
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