NPI age
19 years
Enumerated 2007-03-08
● Active Type 2 · Organization
Eye Clinic Of Sandpoint PA
Eye Clinic Of Sandpoint PA is 1 of 74 eyewear supplier organizations in Idaho.
Primary specialty
Eyewear Supplier
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Petersen
Physician-Owner
Last NPPES update
2018-02-15
Source: monthly bulk 2026-05
How this organization compares
Across 74 active eyewear supplier providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
307 S 1st Ave
Sandpoint, ID 838641201
Mailing address
307 S 1st Ave
Sandpoint, ID 838641201
Authorized official
Jason M Petersen, DO
Physician-Owner
📞 2082638501
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Charles George, MD Ophthalmology NPI 1194733410
- Brayden Petersen, OD Optometrist NPI 1932767753
- Jason Petersen, O.D. Optometrist NPI 1407235948
Specialties
-
Eyewear Supplier PrimaryAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 0377150001 | NORIDIAN DMERC SUPPLIER |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 74 Eyewear Supplier providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.