MAPLE GROVE EYECARE PC
NPI 1124684485
Ophthalmology in Boise, ID
About Maple Grove Eyecare Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAPLE GROVE EYECARE PC (NPI 1124684485) is a healthcare organization registered as an ophthalmology in Boise, Idaho and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through November 30, 2027 and lists Matthew D Neale, Practice Owner/ophthalmologist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Maple Grove Eyecare Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Maple Grove Eyecare PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Madison, WI 53792
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 13D2000453
Maple Grove Eye Care · Boise, IDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Maple Grove Eyecare PC's NPI number?
The NPI number for Maple Grove Eyecare PC is 1124684485. It was assigned to this organization in the NPPES registry on May 13, 2019.
Where is Maple Grove Eyecare PC located?
Maple Grove Eyecare PC is located at 8955 W Hackamore Dr, Boise, ID 83709. The listed phone number is (208) 344-7944.
What is Maple Grove Eyecare PC's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Maple Grove Eyecare PC enrolled in Medicare?
Yes. Maple Grove Eyecare PC is registered in the Medicare PECOS enrollment system.
When is Maple Grove Eyecare PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Idaho, Physician - General Surgery) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Maple Grove Eyecare PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Maple Grove Eyecare PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Ophthalmology (3) and Optometry (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Maple Grove Eyecare PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2000453) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Maple Grove Eyecare PC accept?
Health plans from Moda Health Plan, Inc. and Molina Healthcare list Maple Grove Eyecare PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Maple Grove Eyecare PC was last updated on May 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Maple Grove Eyecare Pc · NPI 1124684485
Ophthalmology organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since May 13, 2019.
## Identity
- **NPI:** 1124684485 (Entity type: Organization)
- **Enumerated:** May 13, 2019
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **Organization subpart:** No
- **Authorized official:** Matthew Neale, PRACTICE OWNER/OPHTHALMOLOGIST
## Practice location
- **Address:** 8955 W HACKAMORE DR, Boise, ID 83709
- **Phone:** (208) 344-7944 · **Fax:** (208) 343-4676
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (DME, Idaho, Physician - General Surgery) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Ophthalmology (3), Optometry (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2019
- **Other identifiers:** Medicaid 1184885345 (OR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124684485) · Data from the CMS NPPES public registry.