NPI age
19 years
Enumerated 2006-08-03
● Active Type 2 · Organization
Eye Clinic Of Sandpoint PA
Eye Clinic Of Sandpoint PA is 1 of 122 ophthalmology organizations in Idaho.
Primary specialty
Ophthalmology
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Petersen
Physician-Owner
Last NPPES update
2018-06-19
Source: monthly bulk 2026-05
How this organization compares
Across 122 active ophthalmology providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 27% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
307 S 1st Ave
Sandpoint, ID 83864
Mailing address
307 S 1st Ave
Sandpoint, ID 838641201
Authorized official
Jason M Petersen, OD
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
-
Ophthalmology PrimaryAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual...
-
Eyewear SupplierAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1215945431 |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- 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.