Individual provider Active NPI

Bruno Himmler, MD

  • Family Medicine Physician
  • Pocatello, ID
National Provider Identifier
1235174582
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5824 Issued in SD
Practice address
5295 W Buckskin Rd
Pocatello, ID 83201-9124
Phone
(208) 231-4456
NPI assigned
Jun 19, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5824 SD Primary

Addresses

Primary practice location

5295 W Buckskin Rd
Pocatello, ID 83201-9124

Mailing address

5295 W Buckskin Rd
Pocatello, ID 83201-9124
Phone (208) 231-4456

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000713 ID Practitioner - Family Practice 5698740025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health West IncGroup PAC ID 4981500931, shared by 30 NPIs, 67 clinicians

Practice addresses (Care Compare)

465 Memorial Dr
Pocatello, ID 83201-4008
Phone 20823278621122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5824SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health West, Inc. Current Accepting new patients
Health West, Inc. CurrentSince Jul 8, 2025 Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Health West, Inc. CurrentSince Jul 8, 2025 Accepting new patients
Health West, Inc. Past Accepting new patients
Health West, Inc. Past Accepting new patients
Health West, Inc. Past Accepting new patients

Locations

465 Memorial Dr
Pocatello, ID 83201
Phone (208) 234-4700

500 S 11th Ave
Ste 400
Pocatello, ID 83201

Interoperability endpoints

  • Direct secure messaging: bruno.himmler.1@16258.direct.athenahealth.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1235174582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5295 W BUCKSKIN RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832019124",
            "telephone_number": "208-231-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 W BUCKSKIN RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832019124",
            "telephone_number": "208-231-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMMLER",
        "first_name": "BRUNO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "5824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.