Diamond Peak Idaho
NPI 1588039127ActiveOrganization· Optometrist· Rexburg, ID
Optometrist in Rexburg, Idaho, registered in NPPES in December 2015. The authorized official on file is Wade Demordaunt, O.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1588039127 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 8, 2015 |
| Last updated in NPPES | Feb 4, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | ODP-959 | ID |
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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