Active NPI
Roger A Cook, MD
- Anesthesiology Physician
- Pocatello, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- M11396
- Practice address
- 777 Hospital Way
Pocatello, ID 83201-5175 - Phone
- (208) 239-1000
- NPI assigned
- Jan 11, 2007
- Last updated
- May 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD229174 | OR | |
| Anesthesiology Physician | 207L00000X | M11396 | ID | Primary |
| Anesthesiology Physician | 207L00000X | 11302 | MT | |
| Anesthesiology Physician | 207L00000X | MD-54947 | IA |
Addresses
Primary practice location
777 Hospital Way
Pocatello, ID 83201-5175
Mailing address
PO Box 4107
Pocatello, ID 83205-4107
Phone (208) 233-8880
Other practice location 1
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2320
Other practice location 2
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003966227 | Medicaid | ID | |
| 11302 | Other | MT | MONTANA LICENSE NUMBER |
| M11396 | Other | ID | IDAHO MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641
333 N 18TH Ave
Suite C
Pocatello, ID 83201-3358
Phone (208) 234-7800
777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-54947 | IA | MD | Anesthesiology Physician |
| M11396 | ID | MD | Anesthesiology Physician |
| 11302 | MT | MD | Anesthesiology Physician |
| MD229174 | OR | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Idaho PLLC | Anesthesiology | Current | Accepting new patients |
| Anesthesia Associates of Great Falls LLC | Anesthesiology | Past | Accepting new patients |
Locations
333 N 18th Ave
Ste C
Pocatello, ID 83201
Phone (208) 234-7800
777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Pocatello, ID
- NPI 1912686882
-
- Anesthesiology Physician
- Portland, OR
- NPI 1841217817
-
- Anesthesiology Physician
- Great Falls, MT
- NPI 1922007202
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Portneuf Rehabilitation Center
- Rehabilitation Hospital Unit
- Pocatello, ID
- NPI 1144262114
-
dba Portneuf Medical Center
- General Acute Care Hospital
- Pocatello, ID
- NPI 1790751055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1003966227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4107",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832054107",
"telephone_number": "208-233-8880",
"fax_number": "208-232-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 HOSPITAL WAY",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015175",
"telephone_number": "208-239-1000"
}
],
"practiceLocations": [
{
"address_1": "200 Hawkins Dr",
"address_purpose": "LOCATION",
"city": "Iowa City",
"state": "IA",
"postal_code": "522421009",
"country_code": "US",
"telephone_number": "319-356-2320",
"fax_number": "319-384-6265",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3181 SW Sam Jackson Park Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393011",
"country_code": "US",
"telephone_number": "503-494-7641",
"fax_number": "503-494-4661",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOK",
"first_name": "ROGER",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD229174",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "M11396",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MT",
"license": "11302",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IA",
"license": "MD-54947",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003966227",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MONTANA LICENSE NUMBER",
"identifier": "11302",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO MEDICAL LICENSE",
"identifier": "M11396",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.