Ty Bolton Erickson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M-6628 Issued in ID

Practice address

808 Pancheri Drive
Idaho Falls, ID 83402-3344

Phone

(208) 552-6900

Fax

(208) 552-4973

NPI assigned

Nov 7, 2006

Last updated

Sep 9, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, NV2 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

Specialty

Obstetrics/Gynecology

Education

University of Nevada School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William Bee Ririe HospitalGroup PAC ID 9335051747, 40 clinicians

Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Women's Healthcare Associates, P.a.Group PAC ID 3577540616, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• William Bee Ririe Hospital Hospital, Ely, NV, CCN 291302
• Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: terickson115947@direct.umcsn.com

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.

• Women's Healthcare Associates, P.a.

  dba Rosemark WomenCare Specialists and/or Margaret Huggins, MD

  • Obstetrics & Gynecology Physician
  • Idaho Falls, ID
  • NPI 1255400636
  Medicare reassignment Care Compare group NPD
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  Medicare reassignment Care Compare group NPD
• William Bee Ririe Hospital

  • Critical Access Hospital
  • Ely, NV
  • NPI 1487648804
  Medicare reassignment Care Compare group NPD
• Unlv Medicine

  dba Mojave Pharmacy

  • Community/Retail Pharmacy
  • Las Vegas, NV
  • NPI 1184152274
  NPD
• Unlv Medicine

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1851811525
  NPD
• William Bee Ririe Retail Pharmacy

  • Community/Retail Pharmacy
  • Ely, NV
  • NPI 1831729268
  NPD
• Angel Wings Center of Healing

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1215159819
  NPD (past)

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

• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• William Bee Ririe Hospital

  • Critical Access Hospital
  • Ely, NV
  • NPI 1487648804
  Care Compare affiliation

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1083783823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 CHANNING WAY PMB #135",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048034",
            "telephone_number": "208-552-6914",
            "fax_number": "208-552-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 PANCHERI DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023344",
            "telephone_number": "208-552-6900",
            "fax_number": "208-552-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "TY",
        "middle_name": "BOLTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-6628",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "6388670-1205",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "ID",
            "license": "M6628",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "UT",
            "license": "6388670-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003678800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric G Baird MD PA
• Erickson Services LLC (Senior Helpers)
• Caitlin Erickson
• Hadynn Erickson, RBT
• Lincoln Andrew Erickson, RBT
• Valerie Erickson
• Brad C Erikson, DO
• Erm Surgical LLC
• Eslim LLC
• Leland Eugene Eslinger, LCPC

• Obstetrics & Gynecology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.

Verify at the official NPI Registry.