NPIMap

Organization Active NPI

Cascade Medical Center Hospital District

  • Rural Health Clinic/Center
  • Cascade, ID
National Provider Identifier
1003988825
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Practice address
402 Lake Cascade Pkwy
Cascade, ID 83611-7702
Phone
(208) 382-4242
NPI assigned
Nov 15, 2006
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Sarah Hasbrouck
Title
Business Office Manager
Phone
(208) 408-5025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

402 Lake Cascade Pkwy
Cascade, ID 83611-7702

Mailing address

PO Box 1330
Cascade, ID 83611-1330
Phone (208) 382-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040309001351 ID Part B Supplier - Clinic/Group Practice 6103739719 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Cascade, ID
O20050317000423 ID Part A Provider - Rural Health Clinic 6103739719 Practice locations: Cascade, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003988825. Details of each certification follow.

Rural health clinic certification: CCN 133993

Legal name
CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Doing business as
CASCADE FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 17, 1999
Last certification
Jul 31, 2019
Ownership / control type
2A
Organization structure
OtherNon-profit
Enrollment address
402 Lake Cascade Pkwy
Cascade, ID 83611-7702
Related CCNs
130779

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2051293Cascade Family Practice402 Lake Cascade Pkwy, Cascade, ID 83611Certificate of waiverDec 16, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Allan Reinhardt Individual Corporate Officer Nov 26, 2018
Sarah Hasbrouck Individual W-2 Managing Employee Apr 16, 2018
Cascade Medical Center Hospital District Organization, Cascade, ID Other Sep 20, 1995 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cascade Medical Center Hospital DistrictCascade, ID, CCN 130779 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 12, 1984
Cascade Medical Center Donnelly ClinicDonnelly, ID, CCN 138537 Rural health clinic Operational/Managerial Control (100%) Mar 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1003988825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "CASCADE",
            "state": "ID",
            "postal_code": "836111330",
            "telephone_number": "208-382-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LAKE CASCADE PKWY",
            "city": "CASCADE",
            "state": "ID",
            "postal_code": "836117702",
            "telephone_number": "208-382-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE MEDICAL CENTER HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "HASBROUCK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "208-408-5025"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cascade, ID

Sources for this page

Verify at the official NPI Registry.