Eyedaho Optometric LLC
NPI 1417627480 · Optometrist · Idaho Falls, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Eyedaho Optometric LLC is a Optometrist organization in Idaho Falls, ID (NPI 1417627480).
Provider details
- NPI number
- 1417627480
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Trevor Dickson, Owner(208) 709-5371
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-09-20
- Last updated
- 2021-09-20
- Certified
- 2021-09-02
Frequently asked questions
- What is Eyedaho Optometric LLC's NPI number?
- Eyedaho Optometric LLC's National Provider Identifier (NPI) is 1417627480, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Eyedaho Optometric LLC?
- Eyedaho Optometric LLC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Eyedaho Optometric LLC located?
- Eyedaho Optometric LLC's practice location on file with NPPES is 500 S Utah Ave, Idaho Falls, ID 83402-3305.
- What is Eyedaho Optometric LLC's phone number?
- The practice phone number listed in the NPPES registry for Eyedaho Optometric LLC is (208) 528-8643.
- Does Eyedaho Optometric LLC accept Medicare?
- Eyedaho Optometric LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Eyedaho Optometric LLC?
- The authorized official listed on Eyedaho Optometric LLC's NPPES record is Trevor Dickson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Eyedaho Optometric LLC's NPI active?
- Yes — Eyedaho Optometric LLC's NPI (1417627480) is active in the NPPES registry as of the last update on 2021-09-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.