NPIMap

Individual provider Active NPI

Roxanne Haslam, MD

  • Urology Physician
  • Coeur d'Alene, ID
National Provider Identifier
1205368198
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-16728 Issued in ID
Practice address
980 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-2668
Phone
(208) 667-0621
Fax
(208) 664-1709
NPI assigned
Mar 30, 2017
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X M-16728 ID Primary

Addresses

Primary practice location

980 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-2668

Mailing address

980 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-2668
Phone (208) 667-0621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220819002552 ID Practitioner - Urology 6608149240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Idaho Urology PLLCGroup PAC ID 1456452291, 9 clinicians

Practice addresses (Care Compare)

980 W Ironwood Dr
Suite 104
Coeur D Alene, ID 83814-2668
Phone (208) 667-0621

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
North Idaho Urology, PLLC Urology CurrentSince Oct 1, 2022 Accepting new patients
Kootenai Health, Inc. Urology PastSince Jul 17, 2022 Accepting new patients

Locations

980 W Ironwood Dr
Ste 104
Coeur D Alene, ID 83814
Phone (208) 667-0621

420 N Second Ave
Sandpoint, ID 83864
Phone (208) 263-2173

Interoperability endpoints

  • Direct secure messaging: rhaslam680775@direct.multicare.org

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 7

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1205368198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR STE 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-667-0621",
            "fax_number": "208-664-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR STE 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-667-0621",
            "fax_number": "208-664-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "ROXANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M-16728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.