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KETCHUM EYECENTER
NPI 1174632244
Optometrist in Ketchum, ID

Active since August 30, 2006
180 1ST AVE N, KETCHUM, ID 83340(208) 726-3363(208) 726-0138 Get Directions Write a Review

NPPES record last updated: January 8, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ketchum Eyecenter NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETCHUM EYECENTER (NPI 1174632244) is a healthcare organization registered as an optometrist in Ketchum, Idaho and active in the NPI registry since August 2006. The organization lists Robert B Grill, Owner Optometrist, as its authorized official.

NPPES Registry Identity

NPI1174632244
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameEYECENTER PA
Location Address180 1ST AVE NKetchum, ID 83340-6129
Mailing AddressPo Box 6129Ketchum, ID 83340-6129 · (208) 726-3363 · Fax (208) 726-0138
Phone(208) 726-3363
Fax(208) 726-0138
Organization SubpartYes
Authorized OfficialRobert B GrillOwner Optometrist · (208) 734-9800
Enumeration DateAugust 30, 2006
Last NPPES UpdateJanuary 8, 2008
✔ NPI 1174632244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
180 1ST AVE N, Ketchum, ID 83340
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Other Names 1

Doing Business AsKetchum Eyecenter

Other Identifiers 3

Medicare NSC0392220004
OtherCP7637Travelers Rr Medicare Grp
Medicare ID-Type Unspecified1371254

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ketchum Eyecenter is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Ketchum Eyecenter, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Kyle Williams, OD
Optometry
NPI 1649381955
180 1ST AVE N
Ketchum, ID 83340
(208) 726-3363
✔ PECOS✔ Accepts MedicareSame address
James Davis, OD
Optometry
NPI 1164533485
201 SOUTH LINCOLN
Jerome, ID 83338
(208) 324-4363
✔ PECOS✔ Accepts Medicare66 mi
Katherine Grill Nate, OD
Optometry
NPI 1023498037
844 SHOSHONE ST E
Twin Falls, ID 83301
(208) 734-9800
✔ PECOS✔ Accepts Medicare77 mi
Robert Grill, OD
Optometry
NPI 1639280951
844 SHOSHONE ST E
Twin Falls, ID 83301
(208) 734-9800
✔ PECOS78 mi
Kory Shaw, OD
Optometry
NPI 1750996740
844 SHOSHONE ST E
Twin Falls, ID 83301
(208) 734-9800
✔ PECOS✔ Accepts Medicare78 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Eyecenter PA's NPI number?

The NPI number for Eyecenter PA is 1174632244. It was assigned to this organization in the NPPES registry on August 30, 2006. The provider is doing business as Ketchum Eyecenter.

Where is Eyecenter PA located?

Eyecenter PA is located at 180 1st Ave N, Ketchum, ID 83340. The listed phone number is (208) 726-3363.

What is Eyecenter PA's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Eyecenter PA enrolled in Medicare?

Yes. Eyecenter PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eyecenter PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Optometry, reassign their Medicare billing to Eyecenter PA. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Eyecenter PA accept?

Health plans from Molina Healthcare list Eyecenter PA 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 Eyecenter PA was last updated on January 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.