Individual provider Active NPI

Karma Youngstrom, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1093186280
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1304 Issued in ID
Practice address
2730 Channing Way
Idaho Falls, ID 83404-5049
Phone
(208) 542-7100
NPI assigned
Oct 13, 2015
Last updated
Oct 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1304 ID Primary

Addresses

Primary practice location

2730 Channing Way
Idaho Falls, ID 83404-5049

Mailing address

2730 Channing Way
Idaho Falls, ID 83404-5049
Phone (208) 542-7100

Other names 1

  • Karma R Risenmay Former name

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
I20151125000914 ID Practitioner - Physician Assistant 4284934175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310

2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823

2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

2730 Channing Way
Idaho Falls, ID 83404-5049
Phone (208) 542-7100

2770 Cortez Ave
Idaho Falls, ID 83404-7590
Phone (208) 522-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Oct 17, 2015 Accepting new patients
Community Care Current Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

2770 Cortez Ave
Idaho Falls, ID 83404
Phone (208) 522-4000

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

72 E Main St
Rexburg, ID 83440
Phone (208) 359-1770

Organizations & group practices 4

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 3

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1093186280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045049",
            "telephone_number": "208-542-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045049",
            "telephone_number": "208-542-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGSTROM",
        "first_name": "KARMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARMA",
            "last_name": "RISENMAY",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.