Individual provider Active NPI

Torbjorg Holtestaul, MD

  • Surgery Physician
  • Fort Campbell, KY
National Provider Identifier
1295275428
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
31161 Issued in NE
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8400
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9471653 ID
Surgery Physician 208600000X 31161 NE Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8400

Other practice location 1

520 S Eagle Rd Ste 1241
Meridian, ID 83642-6355
Phone (208) 381-6930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA, ID, NE4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20250428000991 WI Practitioner - General Surgery 3274059878 Reassigns benefits to 4 organizations
I20250505002990 IA Practitioner - General Surgery 3274059878 Reassigns benefits to 1 organization
I20250520005065 ID Practitioner - General Surgery 3274059878 Reassigns benefits to 1 organization
I20250530001570 NE Practitioner - General Surgery 3274059878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Colorado School of Medicine, Aurora, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians
Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, shared by 9 NPIs, 126 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

143 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711

9850 St Lukes Dr
Nampa, ID 83687-7912

9850 W St Luke's Dr
Nampa, ID 83687-7912

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9471653IDMDSurgery Physician
31161NEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Surgery CurrentSince May 9, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 9, 2025 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin CurrentSince Apr 9, 2025 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Physicians Clinic Inc Surgery CurrentSince May 1, 2025 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

201 Ridge St
Ste 214
Council Bluffs, IA 51503
Phone (712) 328-2616

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

100 E Warm Springs Ave
#B
Boise, ID 83712
Phone (208) 381-6930

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

520 S Eagle Rd
Ste 1241
Meridian, ID 83642
Phone (208) 288-2255

9850 W St Lukes Dr
Ste 260
Nampa, ID 83687
Phone (208) 381-3915

29980 Network Pl
Chicago, IL 60673

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

110 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2351

143 S Gibson St
Medford, WI 54451
Phone (715) 748-2121

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: tholtestaul373225@direct.aspirus.org

Organizations & group practices 12

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 3

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": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1295275428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S Eagle Rd Ste 1241",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426355",
            "country_code": "US",
            "telephone_number": "208-381-6930",
            "fax_number": "208-381-6931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLTESTAUL",
        "first_name": "TORBJORG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "9471653",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "31161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.