NPIMap

Individual provider Active NPI

Lyndal E Stoutin, M.D.

  • Interventional Pain Medicine Physician
  • Lewiston, ID
National Provider Identifier
1245240761
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
M-5693 Issued in ID
Practice address
2841 Juniper Dr
Lewiston, ID 83501-4719
Phone
(208) 743-9712
Fax
(208) 298-0212
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X M-5693 ID Primary

Addresses

Primary practice location

2841 Juniper Dr
Lewiston, ID 83501-4719

Mailing address

2841 Juniper Dr
Lewiston, ID 83501-4719
Phone (208) 743-9712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060330000708 ID Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 1254326564 Reassigns benefits to 1 organization
I20061026000649 WA Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 1254326564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Southern Illinois University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Memorial HospitalGroup PAC ID 4082502422, shared by 3 NPIs, 33 clinicians

Practice addresses (Care Compare)

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (509) 758-5511

PO Box
Suite 189
Clarkston, WA 99403-0189

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-5693IDMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Memorial Hospital CurrentSince Dec 1, 2025 Accepting new patients
Tri-State Memorial Hospital CurrentSince Jan 1, 2017 Accepting new patients
Tri-State Memorial Hospital CurrentSince Mar 18, 2016 Accepting new patients
Tri-State Memorial Hospital CurrentSince Mar 18, 2016 Accepting new patients
Cornerstone Anesthesia PA Past Accepting new patients
Interventional Pain Consultants PA Interventional Pain Medicine PastSince Apr 1, 2006 Accepting new patients

Locations

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

2841 Juniper Dr
#2
Lewiston, ID 83501
Phone (208) 848-9001

1119 Highland Ave
Ste 11
Clarkston, WA 99403
Phone (509) 758-4450

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

1119 Highland Ave
Clarkston, WA 99403
Phone (509) 758-1450

Interoperability endpoints

  • Direct secure messaging: lyndal.stoutin@tsmh.medicity.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1245240761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 JUNIPER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014719",
            "telephone_number": "208-743-9712",
            "fax_number": "208-298-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 JUNIPER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014719",
            "telephone_number": "208-743-9712",
            "fax_number": "208-298-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUTIN",
        "first_name": "LYNDAL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "ID",
            "license": "M-5693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.