DR. AMANDA LEANNE MOORE-ELCYZYN (O.D.) – Optometrist, NPI 1780612499
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
268 OPTOMETRY in ID
Provider Addresses for DR. AMANDA LEANNE MOORE-ELCYZYN (O.D.)
1926 W State St
Boise, ID 837023957
Phone: (208) 336-2020
Type: Location
West State Street, Boise, Ada County, Idaho, 83707, United States
BOISE, ID 837023957
Phone: (208) 336-2020
Fax: (208) 384-5677
Type: Mailing
113, West Carpenter Street, Benton, Saline County, Arkansas, 72015, United States
BENTON, AR 720153317
Phone: (501) 778-2363
Fax: (501) 778-5329
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $208.
Total Amount is formed as General ($208) + Research ($0) + Ownership ($0) = $208.
Last reported payment date: 2023-10-25 • Largest payer in this snapshot: CooperVision Inc. ($104).
Total Amount
$208
General + Research + Ownership
Payments
3
Total payment records
General Amount
$208
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $104 |
| Alcon Vision LLC | $89 |
| ABBVIE INC. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-09-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060925000281 | I | Optometry | AR | TBD |
| I20200902003571 | I | Optometry | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 27 | 27 | $0 |
| 92250 | Photography of the retina | 20 | 20 | $0 |
Insurance plans in this area (ZIP 83702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | ID | |
| O P T O M E T R Y | ID | |
| - | ID |
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