DIAMOND PEAK IDAHO
NPI 1588039127
Optometrist in Rexburg, ID

Q: What is Diamond Peak Idaho's NPI number?

The NPI number for Diamond Peak Idaho is 1588039127. It was assigned to this organization in the NPPES registry on December 8, 2015.

Q: What is Diamond Peak Idaho's specialty?

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

Active since December 08, 2015

1450 N 2ND E, REXBURG, ID 83440(208) 497-6406(208) 359-3007 Get Directions Write a Review

NPPES record last updated: February 4, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 4, 2016, Dec 8, 2015 (2 updates tracked since 2015).

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About Diamond Peak Idaho NPPES

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

DIAMOND PEAK IDAHO (NPI 1588039127) is a healthcare organization registered as an optometrist in Rexburg, Idaho and active in the NPI registry since December 2015. The organization lists Wade Demordaunt, Owner, as its authorized official.

NPPES Registry Identity

NPI1588039127

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameDIAMOND PEAK IDAHO

Location Address1450 N 2ND ERexburg, ID 83440-5131

Mailing AddressPo Box 158Rexburg, ID 83440-0158 · (208) 497-6406 · Fax (208) 359-3007

Phone(208) 497-6406

Fax(208) 359-3007

Organization SubpartNo

Authorized OfficialWade DemordauntOwner · (925) 222-1957

Enumeration DateDecember 8, 2015

Last NPPES UpdateFebruary 4, 20162 updates tracked since enumeration

✔ NPI 1588039127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in ID · ODP-959

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.

1450 N 2ND E, Rexburg, ID 83440

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Other Identifiers 2

Medicare PINZ164411

Medicare UPINU65669

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 Blue Cross and Blue Shield of Louisiana, University of Utah Health Plans.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)

Diamond Peak Idaho is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Diamond Peak Idaho, which bills Medicare for the services this clinician delivers.

Clinician (1)

Wade Demordaunt, O.D.

Optometry

NPI 1275591711

1450 N 2ND E
Rexburg, ID 83440

(208) 497-6406

✔ PECOS✔ Accepts Medicare4.2 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 Diamond Peak Idaho's NPI number?

The NPI number for Diamond Peak Idaho is 1588039127. It was assigned to this organization in the NPPES registry on December 8, 2015.

Where is Diamond Peak Idaho located?

Diamond Peak Idaho is located at 1450 N 2nd E, Rexburg, ID 83440. The listed phone number is (208) 497-6406.

What is Diamond Peak Idaho's specialty?

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

Is Diamond Peak Idaho enrolled in Medicare?

Yes. Diamond Peak Idaho is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Diamond Peak Idaho?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Diamond Peak Idaho. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Diamond Peak Idaho accept?

Health plans from Blue Cross and Blue Shield of Louisiana and University of Utah Health Plans list Diamond Peak Idaho 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 Diamond Peak Idaho was last updated on February 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.