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LANDON KELLY GRANGE M.D. NPI 1043620255


NPI Information

NPI: 1043620255
Provider Name: LANDON KELLY GRANGE, M.D.
Classification: Ophthalmology - 207W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5680 W GAGE ST
BOISE, ID
ZIP 83706
Phone: (208) 773-3937
Get Directions

Landon Kelly Grange, M.D. is an ophthalmology in Boise, ID with 10 years of experience. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. Landon Kelly Grange, M.D. NPI is 1043620255. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

5680 W GAGE ST
BOISE, ID
ZIP 83706
Phone: (208) 773-3937
Fax: (208) 377-3937

The NPI 1043620255 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Diagnostic imaging of retina (HCPCS:92134)
  • Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
  • Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • Measurement of field of vision during daylight conditions (HCPCS:92083)

The enumeration date for this NPI number is 4/28/2014 and was last updated on 7/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyM14219IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11043620255MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.