NPIMap

Organization Active NPI

Orthopedic Surgery and Sports

  • Orthopaedic Surgery Physician
  • Coeur d'Alene, ID
National Provider Identifier
1083729438
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC SURGERY AND SPORTS
Practice address
850 W Ironwood Dr Ste 202
Coeur D Alene, ID 83814-4903
Phone
(208) 664-2175
Fax
(208) 664-1226
NPI assigned
Aug 19, 2006
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Mr. Roger C Dunteman, MDNPI 1740390137
Title
Owner/Partner
Phone
(208) 664-2175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

850 W Ironwood Dr Ste 202
Coeur D Alene, ID 83814-4903

Mailing address

850 W Ironwood Dr
Suite 202
Coeur D Alene, ID 83814-4903
Phone (208) 664-2175

Other practice location 1

8468 N Wayne Dr
Hayden, ID 83835-6025
Phone (208) 601-6060

Other practice location 2

14775 N Kimo Ct Ste 1
Rathdrum, ID 83858-8762
Phone (208) 687-9240

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040902001125 ID Part B Supplier - Clinic/Group Practice 3375519168 Receives reassigned benefits from 31 practitioners
Practice locations: Coeur D Alene, ID; Hayden, ID; Post Falls, ID; Rathdrum, ID
O20110420000401 ID DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3375519168 Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory

Locations

1812 N Lakewood Dr
Ste 100
Coeur D Alene, ID 83814
Phone (208) 770-2971

8468 N Wayne Dr
Hayden, ID 83835
Phone (208) 601-6060

Interoperability endpoints

  • Direct secure messaging: dmcinnis@ossmidaho.exscribedirect.com
  • Direct secure messaging: jking@ossmidaho.exscribedirect.com
  • Direct secure messaging: rdunteman@ossmidaho.exscribedirect.com

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1083729438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR",
            "address_2": "SUITE 202",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-664-2175",
            "fax_number": "208-664-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR STE 202",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-664-2175",
            "fax_number": "208-664-1226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8468 N Wayne Dr",
            "address_purpose": "LOCATION",
            "city": "Hayden",
            "state": "ID",
            "postal_code": "838356025",
            "country_code": "US",
            "telephone_number": "208-601-6060",
            "fax_number": "208-635-5098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14775 N Kimo Ct Ste 1",
            "address_purpose": "LOCATION",
            "city": "Rathdrum",
            "state": "ID",
            "postal_code": "838588762",
            "country_code": "US",
            "telephone_number": "208-687-9240",
            "fax_number": "208-687-9241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGERY AND SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "DUNTEMAN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "208-664-2175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.