Upper Valley ENT & Allergy PLLC

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

UPPER VALLEY ENT & ALLERGY PLLC

Practice address

256 N 2ND E
Rexburg, ID 83440-1638

Phone

(208) 656-9646

Fax

(208) 656-9645

NPI assigned

Apr 17, 2013

Last updated

Jun 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jay Robert McMaster, DONPI 1972537892

Title

Physician/Surgeon

Phone

(208) 656-9646

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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.

• Jay Robert McMaster, DO

  • Otolaryngology/Facial Plastic Surgery Physician
  • Rexburg, ID
  • NPI 1972537892

  Allergy

  Medicare reassignment Care Compare group NPD Authorized official
• Barry John Peterson, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Rexburg, ID
  • NPI 1447456272
  Medicare reassignment Care Compare group
• Dan Loren Weber, PA-C

  • Physician Assistant
  • Rexburg, ID
  • NPI 1962438812
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1124462494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 N 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401638",
            "telephone_number": "208-656-9646",
            "fax_number": "208-656-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401638",
            "telephone_number": "208-656-9646",
            "fax_number": "208-656-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY ENT & ALLERGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "MCMASTER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN/SURGEON",
        "authorized_official_telephone_number": "208-656-9646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upper Valley Audiology LLC
• Upper Valley Community Health Services Inc (Grand Peaks Medical)
• Upper Valley Community Health Services Inc (Grand Peaks Pharmacy)
• Upper Valley Community Health Services Inc (Grand Peaks Behavioral Health)
• Upper Valley Community Health Services Inc (Grand Peaks Dental)
• Upper Valley Family Practice, PLLC
• Upper Valley Options, Inc.
• Upper Valley Orthopedics, PLLC
• Upper Valley Pediatrics
• Upper Valley Resource and Counseling Center

• Otolaryngology/Facial Plastic Surgery Physician in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.