Premier Eye Care of Eastern Idaho

Public-record details

Address

2100 Providence Way, Idaho Falls, ID 83404

Phone

(208) 529-6600

Listed under

Ophthalmology practices, Medicare-enrolled groups (CMS)

NPI

1790052603

NPI status

Active in the NPPES registry

Provider type

Organization (practice, clinic or company)

Registered specialty (self-reported taxonomy)

Ophthalmology (207W00000X)

License number on NPI record

M10686 (ID)

Authorized official

Matthew Traynor, MD, Owner

NPI first issued

Nov 20, 2011

Years since NPI first issued

15 years (since 2011)

License state on NPI record

ID

NPI record last updated

Aug 12, 2026

Medicare group enrollment (CMS)

Enrolled: listed in CMS Doctors & Clinicians as Premier Eye Care of Eastern Idaho

Clinicians in the Medicare group (all specialties, CMS)

11

Optometrists and ophthalmologists in the group at this ZIP (CMS)

11

Group Medicare assignment (CMS)

Accepts the Medicare-approved amount as payment in full

NPI 1790052603 is active in the federal NPPES registry (CMS) with Ophthalmology as its self-reported primary taxonomy; license M10686 (ID) is listed on the record. CMS Doctors & Clinicians lists a Medicare-enrolled group with this name at this ZIP. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Eye Doctor Index does not vet, employ, recommend or guarantee eye care practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Eye Doctor Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. Ophthalmologists are physicians (MD or DO) who diagnose and treat eye disease and perform eye surgery. Verify a surgeon's license with the state medical board and board certification with the American Board of Ophthalmology.

View NPI 1790052603 in the official registry ↗