Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Chad Clark, OD

Individual provider Optometrist · NPI 1205241577

Dr. Chad Clark, OD is an Optometry in Boise, Idaho. Qualified in 2014, 12 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
12
Licensed in
ID
In the registry since
2014
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1205 S Five Mile Rd
Boise, ID 83709-1304
Phone: (208) 322-8381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence ODP-100308 (ID)

Record details

NPI number1205241577
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJune 25, 2014
Last updated in NPPESNovember 14, 2022
Certification dateNovember 14, 2022
Mailing address1205 S Five Mile Rd, Boise, ID 83709-1304

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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