Individual provider Active NPI

Roger A Cook, MD

  • Anesthesiology Physician
  • Pocatello, ID
National Provider Identifier
1003966227
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M11396 Issued in ID
Practice address
777 Hospital Way
Pocatello, ID 83201-5175
Phone
(208) 239-1000
NPI assigned
Jan 11, 2007
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1003966227MedicaidID
11302OtherMTMONTANA LICENSE NUMBER
M11396OtherIDIDAHO MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120121000075 ID Practitioner - Anesthesiology 1850484312 Reassigns benefits to 1 organization
I20260415003465 OR Practitioner - Anesthesiology 1850484312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiology Associates LLCGroup PAC ID 6901702869, 239 clinicians
Northstar Anesthesia of Idaho PLLCGroup PAC ID 6204283856, 37 clinicians

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

LicenseStateTypeSpecialty
MD-54947IAMDAnesthesiology Physician
M11396IDMDAnesthesiology Physician
11302MTMDAnesthesiology Physician
MD229174ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Idaho PLLC Anesthesiology CurrentSince Oct 1, 2023 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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.