NPIMap

Individual provider Active NPI

Matthew W Dopp, M.D.

  • Internal Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1255575619
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M11589 Issued in ID
Practice address
2550 Addison Ave E
Suite E
Twin Falls, ID 83301-6749
Phone
(208) 814-7780
Fax
(208) 814-7746
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M11589 ID Primary

Addresses

Primary practice location

2550 Addison Ave E
Suite E
Twin Falls, ID 83301-6749

Mailing address

PO Box 587
Twin Falls, ID 83303-0587
Phone (208) 814-7400

Other identifiers 1

IdentifierTypeStateIssuer
1255575619MedicaidID

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
I20120808000403 ID Practitioner - Internal Medicine 9335395292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
St. Louis College of Physicians and Surgeons, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

2550 Addison Ave E
Twin Falls, ID 83301-6748

746 N College Rd
Twin Falls, ID 83301-3486

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

  • Visions Home Health & Visions Home Care LLC Home health agency, Twin Falls, ID, CCN 137107
  • Idaho Home Health & Hospice Home health agency, Twin Falls, ID, CCN 137014
  • Heritage Home Health Home health agency, Pocatello, ID, CCN 137117
  • Hospice Visions Hospice, Twin Falls, ID, CCN 131524
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Jerome Hospital, Jerome, ID, CCN 131310
  • Cassia Regional Hospital Hospital, Burley, ID, CCN 131326
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • North Canyon Medical Center Hospital, Gooding, ID, CCN 131302
  • Serenity Transitional Care Nursing home, Twin Falls, ID, CCN 135143
  • Twin Falls Transitional Care of Cascadia Nursing home, Twin Falls, ID, CCN 135104
  • Bridgeview Estates Nursing home, Twin Falls, ID, CCN 135113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M11589IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Clinic LLC Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Twin Falls of Cascadia, LLC Past Accepting new patients
Bridgeview Medical Investors, LLC Past Accepting new patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients
Tanabell Health Services Inc PastSince Sep 1, 2018 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1828 Bridgeview Blvd
Twin Falls, ID 83301
Phone (208) 736-3933

2550 Addison Ave E
Ste E
Twin Falls, ID 83301
Phone (208) 814-7780

2550 Addison Ave E
Ste 8
Twin Falls, ID 83301

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bridgeview EstatesTwin Falls, ID, CCN 135113 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2021
Mar 24, 2026
Serenity Transitional CareTwin Falls, ID, CCN 135143 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2018
Sep 1, 2018
Twin Falls Transitional Care of CacadiaTwin Falls, ID, CCN 135104 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 13, 2016
Feb 12, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1255575619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833030587",
            "telephone_number": "208-814-7400",
            "fax_number": "208-814-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 ADDISON AVE E",
            "address_2": "SUITE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016749",
            "telephone_number": "208-814-7780",
            "fax_number": "208-814-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOPP",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M11589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255575619",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.