DR. JAY LESLIE BORGHOLTHAUS (OD) – Optometrist, NPI 1952353716

DR. JAY LESLIE BORGHOLTHAUS (OD) is a healthcare provider. based in Pocatello, Idaho. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. ODP-865 (ID). The NPI Number for DR. JAY LESLIE BORGHOLTHAUS (OD) is 1952353716

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAY LESLIE BORGHOLTHAUS (OD)
NPI
1952353716
Phone
(208) 637-0841
Address
301 S 4TH AVE # C-2
Enumeration Date
17 May 2006
Last Update Date
22 June 2016

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
2085225594
Graduation Year
1991 (35 years ago)
PAC ID
9032152152
Group Practice PAC ID
4284867888
Professional Enrollment ID
I20050608001125
Address ID
ID834047405ID3351XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

268 OPTOMETRY in ID

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Provider Addresses for DR. JAY LESLIE BORGHOLTHAUS (OD)

  • South 4th Avenue, Pocatello, Bannock County, Idaho, 83209, United States

    POCATELLO, ID 832016462

    Phone: (208) 637-0841

    Fax: (208) 237-6922

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 33 Open Payments records for all available years, with a total value of $874.

Total Amount is formed as General ($874) + Research ($0) + Ownership ($0) = $874.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Alcon Vision LLC ($287).

Total Amount

$874

General + Research + Ownership

Payments

33

Total payment records

General Amount

$874

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-06-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050608001125IOptometryIDTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92250Photography of the retina102101$0
92014Established patient complete exam of visual system7272$0
99213Established patient office or other outpatient visit, 20-29 minutes5939$0
92283Extended exam involving color vision testing2020$0
92004New patient complete exam of visual system1919$0
View full utilization report →

Insurance plans in this area (ZIP 83201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284867888View full group profile
NameSpecialtyState
O P T O M E T R YID
O P T O M E T R YID
O P T O M E T R YID
O P T O M E T R YMN
O P T O M E T R YID
O P T O M E T R YID
O P T O M E T R YID

Reviews

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Frequently asked questions

Can I cross-check DR. JAY LESLIE BORGHOLTHAUS (OD) using NPI 1952353716?
NPI 1952353716 belongs to DR. JAY LESLIE BORGHOLTHAUS (OD); compare other details if you need extra assurance.
Is DR. JAY LESLIE BORGHOLTHAUS (OD) shown as active in public data?
Registry records indicate DR. JAY LESLIE BORGHOLTHAUS (OD) maintains an active NPI.
What clinical focus is listed for DR. JAY LESLIE BORGHOLTHAUS (OD)?
At a glance, DR. JAY LESLIE BORGHOLTHAUS (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Where in Idaho is DR. JAY LESLIE BORGHOLTHAUS (OD) registered?
Use Pocatello, Idaho as the headline location for DR. JAY LESLIE BORGHOLTHAUS (OD) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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