IDAHO EYELID & FACIAL PLASTIC SURGERY , PLLC
NPI 1255401436
Ophthalmology in Boise, ID

Q: What is Idaho Eyelid & Facial Plastic Surgery , PLLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since November 08, 2006

111 W MAIN ST STE 200, BOISE, ID 83702(208) 344-3220(208) 344-0461 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 3, 2020, Mar 31, 2018, Oct 28, 2016 (3 updates tracked since 2016).

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About Idaho Eyelid & Facial Plastic Surgery , Pllc NPPES

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

IDAHO EYELID & FACIAL PLASTIC SURGERY , PLLC (NPI 1255401436) is a healthcare organization registered as an ophthalmology in Boise, Idaho and active in the NPI registry since November 2006. The organization lists Mark J Boerner, Owner, as its authorized official.

NPPES Registry Identity

NPI1255401436

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameIDAHO EYELID & FACIAL PLASTIC SURGERY , PLLC

Location Address111 W MAIN ST STE 200Boise, ID 83702-7308

Mailing Address111 W Main St Ste 200Boise, ID 83702-7308 · (208) 344-3220 · Fax (208) 344-0461

Phone(208) 344-3220

Fax(208) 344-0461

Organization SubpartNo

Authorized OfficialMark J BoernerOwner · (208) 344-3220

Enumeration DateNovember 8, 2006

Last NPPES UpdateApril 3, 20203 updates tracked since enumeration

NPPES CertifiedApril 3, 2020

✔ NPI 1255401436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

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.

Also ListedOptometristTaxonomy 152W00000X

111 W MAIN ST STE 200, Boise, ID 83702

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Other Identifiers 4

Other8F488ID · Blue Cross Of Idaho

Medicaid806295400ID

OtherCJ6700ID · Medicare Rr

Other000010027884ID · Regence Blue Shield

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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)

Idaho Eyelid & Facial Plastic Surgery , Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Idaho Eyelid & Facial Plastic Surgery , PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Mark Boerner, M.D.

Ophthalmology

NPI 1003819459

111 W MAIN ST STE 200
Boise, ID 83702

(208) 344-3220

✔ PECOS✔ Accepts MedicareSame address

Chad Jackson, MD

Ophthalmology

NPI 1184067498

111 W MAIN ST STE 200
Boise, ID 83702

(208) 344-3220

✔ PECOS✔ Accepts MedicareSame address

Christopher Debacker, MD

Ophthalmology

NPI 1316905839

1314 E SONTERRA BLVD SUITE 5104
San Antonio, TX 78258

(210) 495-2367

✔ PECOS✔ Accepts Medicare1,373 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 Idaho Eyelid & Facial Plastic Surgery , PLLC's NPI number?

The NPI number for Idaho Eyelid & Facial Plastic Surgery , PLLC is 1255401436. It was assigned to this organization in the NPPES registry on November 8, 2006.

Where is Idaho Eyelid & Facial Plastic Surgery , PLLC located?

Idaho Eyelid & Facial Plastic Surgery , PLLC is located at 111 W Main St Ste 200, Boise, ID 83702. The listed phone number is (208) 344-3220.

What is Idaho Eyelid & Facial Plastic Surgery , PLLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Idaho Eyelid & Facial Plastic Surgery , PLLC enrolled in Medicare?

Yes. Idaho Eyelid & Facial Plastic Surgery , PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Idaho Eyelid & Facial Plastic Surgery , PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Ophthalmology, reassign their Medicare billing to Idaho Eyelid & Facial Plastic Surgery , PLLC. 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Idaho Eyelid & Facial Plastic Surgery , PLLC accept?

Health plans from Moda Health Plan, Inc. list Idaho Eyelid & Facial Plastic Surgery , PLLC 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 Idaho Eyelid & Facial Plastic Surgery , PLLC was last updated on April 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.