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

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: November 01, 2026.

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

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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Cody Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Boise Vision Care, P.A.
45 mi
Optometrist
3293 N MILWAUKEE ST
Boise, ID 83704
  • Reassigned Medicare billing, Idaho enrollment
  • 4 clinicians in this Medicare group
NPI 1134295116 (208) 322-2020

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

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
Social Worker (Clinical)
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 288-7580
DR. CRAIG LOYD FOLSOM D.D.S.
Dentist
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7300
MCKENZIE LEIGH NUTTER DDS
Military Health Care Provider
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7300
DR. STEPHEN STERLING POTTER DDS
Dentist
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7300
BRANYAN DECARLO GARCIA FNP
Nurse Practitioner (Family)
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7596
MS. JOANNA ELISE WIESE
Psychologist (Prescribing (Medical))
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7581
BICHLE THI NGUYEN D.O.
General Practice
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7401
MICHAEL BOCEK PHARMD
Pharmacist
90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7521

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 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.

Where is Cody Peterson located?

Cody Peterson practices at 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648. The listed phone number is (208) 828-7250.

What is Cody Peterson's specialty?

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

Is Cody Peterson enrolled in Medicare?

Yes. Cody Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Cody Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cody Peterson reassigns Medicare benefits to Boise Vision Care, P.A. (Boise, ID). The 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 Cody Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Cody Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield and Providence Health Plan list Cody Peterson 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 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.