DR. CODY PETERSON O.D.
NPI 1922441245
Optometrist in Mountain Home Afb, ID

Q: What is Cody Peterson's NPI number?

The NPI number for Cody Peterson is 1922441245. It was assigned to this individual provider in the NPPES registry on April 17, 2013.

Q: What is Cody Peterson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Cody Peterson was last updated on July 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 17, 2013PECOS EnrolledAccepts Medicare Assignment

90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648(208) 828-7250 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 19, 2024, Aug 16, 2022, Apr 16, 2021 and 1 more (4 updates tracked since 2018).

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About Dr. Cody Peterson O.d. NPPES

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

DR. CODY PETERSON O.D. (NPI 1922441245) is an individual optometrist in Mountain Home Afb, Idaho, licensed in Idaho (ODP-100285) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1922441245

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. CODY PETERSONCredential: O.D.

Location Address90 HOPE DR BLDG 6000Mountain Home Afb, ID 83648-1062

Mailing Address90 Hope Dr Bldg 6000Mountain Home Afb, ID 83648-1062 · (208) 828-7250

Phone(208) 828-7250

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 17, 2013

Last NPPES UpdateJuly 19, 20244 updates tracked since enumeration

NPPES CertifiedJuly 19, 2024

✔ NPI 1922441245 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-100285

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.

90 HOPE DR BLDG 6000, Mountain Home Afb, ID 83648

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Cody Peterson O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991103517

PECOS Enrollment IDI20260407001339

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83648 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.27 typical visit price

range $52.44 – $160.17

Typical copayment $30.31 (range $13.11 – $40.04)

Most-billed visit code 99204

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON L WILSON LCSW

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