Dr Kristan C Sparks, OD is a medicare enrolled "Optometrist" provider in Shelley, Idaho. He went to Pacific University - College Of Optometry and graduated in 1980 and has 44 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Parkway Eyecare P C and his current practice location is
169 S Emerson Ave, Shelley, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 357-5733.
Dr Kristan C Sparks is licensed to practice in Idaho (license number ODP638) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1174723332.
Healthcare Provider's Profile
| Full Name | Dr Kristan C Sparks |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 44 Years |
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| Location | 169 S Emerson Ave, Shelley, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kristan C Sparks attended and graduated from Pacific University - College Of Optometry in 1980
NPI Data:
- NPI Number: 1174723332
- Provider Enumeration Date: 07/24/2007
- Last Update Date: 07/24/2007
Medicare PECOS Information:
- PECOS PAC ID: 7618938374
- Enrollment ID: I20041029000149
Medical Identifiers
Medical identifiers for Dr Kristan C Sparks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174723332 | NPI | - | NPPES |
| 21776 | Other | ID | SPECTERA |
| V5988 | Other | ID | BLUE CROSS |
| 90638 | Other | ID | VBA |
| 001251300 | Medicaid | ID | |
| 000010015251 | Other | ID | BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | ODP638 (Idaho) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Parkway Eyecare P C | 3274594932 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kristan C Sparks allows following entities to bill medicare on his behalf.
| Provider Name | Parkway Eyecare P C |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1780784769
PECOS PAC ID: 3274594932
Enrollment ID: O20041026000110 |
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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. Dr Kristan C Sparks 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 |
|---|
Dr Kristan C Sparks, OD
Po Box 547,
Shelley, ID 83274-0547
Ph: (208) 357-5733 | Dr Kristan C Sparks, OD
169 S Emerson Ave,
Shelley, ID 83274-1226
Ph: (208) 357-5733 |
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