Teton Valley Vision Pc is a medicare enrolled "Optometrist" provider in Victor, Idaho. Their current practice location is
7389 S Hwy 33, Ste B, Victor, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 787-3937.
Teton Valley Vision Pc is licensed to practice in Idaho (license number ODP-100009) and it also participates in the medicare program. Teton Valley Vision Pc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073918173.
Healthcare Provider's Profile
| Full Name | Teton Valley Vision Pc |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 7389 S Hwy 33, Victor, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073918173
- Provider Enumeration Date: 10/31/2014
- Last Update Date: 10/31/2014
Medicare PECOS Information:
- PECOS PAC ID: 3870715006
- Enrollment ID: O20141104000402
Medical Identifiers
Medical identifiers for Teton Valley Vision Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073918173 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | ODP-100009 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Teton Valley Vision Pc acts as a billing entity for following providers:
| Provider Name | Thomas L Simmons |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1144313305
PECOS PAC ID: 5395639827
Enrollment ID: I20040927000686 |
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| Provider Name | Eliza Whatley |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1376299040
PECOS PAC ID: 9032594882
Enrollment ID: I20240528003030 |
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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. Teton Valley Vision Pc 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 |
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Teton Valley Vision Pc
7389 S Hwy 33, Ste B,
Victor, ID 83455
Ph: () - | Teton Valley Vision Pc
7389 S Hwy 33, Ste B,
Victor, ID 83455
Ph: (208) 787-3937 |
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