Individual provider Active NPI

Anna Martsenyuk, APRN, ACNS-BC

  • Pain Medicine Physician
  • Meridian, ID
National Provider Identifier
1053719161
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
CNS-73A Issued in ID
Practice address
2102 W Everest LN Ste 100
Meridian, ID 83646-7033
Phone
(208) 505-4744
Fax
(844) 402-0970
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X N-38361 ID
Adult Health Clinical Nurse Specialist 364SA2200X CNS-73A ID
Pain Medicine Physician 208VP0000X CNS-73A ID Primary

Addresses

Primary practice location

2102 W Everest LN Ste 100
Meridian, ID 83646-7033

Mailing address

2102 W Everest LN Ste 100
Meridian, ID 83646-7033
Phone (208) 505-4744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150127000941 ID Practitioner - Certified Clinical Nurse Specialist (CNS) 5395069165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Treasure Valley Pain Center LLCGroup PAC ID 5890139240, 3 clinicians

Practice addresses (Care Compare)

2102 W Everest LN
Suite 100
Meridian, ID 83646-7033
Phone (208) 505-4744

2240 W Everest LN
Suite 150
Meridian, ID 83646-6104

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N-38361IDMDRegistered Nurse
CNS-73AIDMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Valley Pain Center, LLC Pain Medicine CurrentSince Feb 15, 2024 Accepting new patients
Richard Radnovich DO PC Past Accepting new patients

Locations

2102 W Everest Ln
#100
Meridian, ID 83646
Phone (208) 505-4744

2240 W Everest Ln
#150
Meridian, ID 83646
Phone (208) 794-1559

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFGFDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFGFDD/Endpoint/CFGFDD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1053719161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 W EVEREST LN STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467033",
            "telephone_number": "208-505-4744",
            "fax_number": "844-402-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 W EVEREST LN STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467033",
            "telephone_number": "208-505-4744",
            "fax_number": "844-402-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTSENYUK",
        "first_name": "ANNA",
        "credential": "APRN, ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N-38361",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "ID",
            "license": "CNS-73A",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "ID",
            "license": "CNS-73A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.