NPIMap

Individual provider Active NPI

Lucie A Dimaggio, M.D.

  • Internal Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1336188267
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8289 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
Jun 6, 2006
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Female
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 M8289 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 2

IdentifierTypeStateIssuer
806143900MedicaidID
P00029389OtherIDRR MEDICARE

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
I20080702000617 ID Practitioner - Internal Medicine 3577646199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8289IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC Internal Medicine CurrentSince Jul 1, 2003 Accepting new patients
Magic Valley Regional Medical Center Past Accepting new patients
St Lukes Regional Medical Center PastSince Oct 1, 2018 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

2001 Bench Rd
Pocatello, ID 83201
Phone (208) 238-1039

2550 Addison Ave E
Ste A
Twin Falls, ID 83301
Phone (208) 814-7700

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

630 Addison Ave W
Ste 110
Twin Falls, ID 83301
Phone (208) 734-0206

660 Shoshone St E
Ste 100
Twin Falls, ID 83301
Phone (208) 732-3020

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 14

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

FacilityTypeRoleSince
St Lukes Magic Valley Regional Medical Center LTDTwin Falls, ID, CCN 130002 Hospital Corporate Director Oct 1, 2018
St Lukes Wood River Medical CenterKetchum, ID, CCN 131323 Hospital Corporate Director Oct 1, 2018
St Lukes Canyon View Behavioral Health ServicesTwin Falls, ID, CCN 13S002 Hospital Corporate Director Oct 1, 2018
St Lukes Wood River Swing BedsKetchum, ID, CCN 13Z323 Hospital Corporate Director Oct 1, 2018
St Lukes McCall Swing BedsMcCall, ID, CCN 13Z312 Hospital Corporate Director Oct 1, 2018
St Lukes McCall Medical CenterMcCall, ID, CCN 131312 Hospital Corporate Director Oct 1, 2018
St Luke's Elmore Swing BedsMountain Home, ID, CCN 13Z311 Hospital Corporate Director Oct 1, 2018
St Lukes Elmore Medical CenterMountain Home, ID, CCN 131311 Hospital Corporate Director Oct 1, 2018
St Lukes JeromeJerome, ID, CCN 131310 Hospital Corporate Director Oct 1, 2018
St Lukes Jerome Swing BedsJerome, ID, CCN 13Z310 Hospital Corporate Director Oct 1, 2018
St Lukes Rehabilitation Inpatient Acute Care UnitBoise, ID, CCN 13T006 Hospital Corporate Director Oct 1, 2018
St Lukes Clinic Jerome Family MedicineJerome, ID, CCN 133992 Rural health clinic Corporate Director Oct 1, 2018
St Lukes Clinic - Salmon River MedicalRiggins, ID, CCN 138516 Rural health clinic Corporate Director Oct 1, 2018
St Lukes Clinic - Eastern Oregan Medical AssociatesBaker City, OR, CCN 383852 Rural health clinic Corporate Director Oct 1, 2018

Owned or controlled facilities with NPI records 15

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

View all 15

Organizations & group practices 3

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 10

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1336188267",
    "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": "208-814-7496"
        },
        {
            "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": "DIMAGGIO",
        "first_name": "LUCIE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806143900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00029389",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.