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HAYDEN VISION SOURCE PLLC
NPI 1548999840
Optometrist in Hayden, ID

Active since June 10, 2022
8445 N GOVERNMENT WAY, HAYDEN, ID 83835(208) 772-3208(208) 762-2574 Get Directions Write a Review

NPPES record last updated: June 10, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Hayden Vision Source Pllc NPPES

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

HAYDEN VISION SOURCE PLLC (NPI 1548999840), doing business as Hayden Vision Source, is a healthcare organization registered as an optometrist in Hayden, Idaho and active in the NPI registry since June 2022. The organization lists Emily Putney, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1548999840
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameHAYDEN VISION SOURCE PLLC
Location Address8445 N GOVERNMENT WAYHayden, ID 83835-9349
Mailing Address8445 N Government WayHayden, ID 83835-9349 · (208) 772-3208 · Fax (208) 762-2574
Phone(208) 772-3208
Fax(208) 762-2574
Organization SubpartNo
Authorized OfficialEmily PutneyCredentialing Specialist · (208) 772-3208
Enumeration DateJune 10, 2022
NPPES CertifiedJune 6, 2022
✔ NPI 1548999840 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.
8445 N GOVERNMENT WAY, Hayden, ID 83835
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Other Names 1

Doing Business AsHayden Vision Source

Other Identifiers 1

Medicaid1780345264ID

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hayden Vision Source Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Hayden Vision Source PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Tyrel Bruneel, OD
Optometry
NPI 1013575851
8445 N GOVERNMENT WAY
Hayden, ID 83835
(208) 772-3208
✔ PECOS✔ Accepts MedicareSame address
Brian Finley, O.D.
Optometry
NPI 1649571118
8445 N GOVERNMENT WAY
Hayden, ID 83835
(208) 772-3208
✔ PECOSSame address
Jett Scrimsher, OD
Optometry
NPI 1912524513
8445 N GOVERNMENT WAY
Hayden, ID 83835
(208) 660-9960
✔ PECOS✔ Accepts MedicareSame address
Robert Sorensen, O.D.
Optometry
NPI 1356335897
8445 N GOVERNMENT WAY
Hayden, ID 83835
(208) 772-3208
✔ PECOS✔ Accepts MedicareSame address
Drew Hargrove, OD
Optometry
NPI 1609552215
7960 W RIFLEMAN ST STE 150
Boise, ID 83704
(208) 377-8899
✔ PECOS✔ Accepts Medicare287 mi
Anna Harding, O.D.
Optometry
NPI 1295187458
1800 FOURTH ST
Livermore, CA 94550
(925) 447-3883
✔ PECOS✔ Accepts Medicare740 mi
Joshua Stommes, OD
Optometry
NPI 1295234763
800 E ATWATER AVE
Bloomington, IN 47405
(812) 855-4447
✔ PECOS✔ Accepts Medicare1,621 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 Hayden Vision Source PLLC's NPI number?

The NPI number for Hayden Vision Source PLLC is 1548999840. It was assigned to this organization in the NPPES registry on June 10, 2022. The provider is doing business as Hayden Vision Source.

Where is Hayden Vision Source PLLC located?

Hayden Vision Source PLLC is located at 8445 N Government Way, Hayden, ID 83835. The listed phone number is (208) 772-3208.

What is Hayden Vision Source PLLC's specialty?

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

Is Hayden Vision Source PLLC enrolled in Medicare?

Yes. Hayden Vision Source PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Hayden Vision Source PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Optometry, reassign their Medicare billing to Hayden Vision Source 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, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Hayden Vision Source PLLC was last updated on June 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.