Stephen A Denagy, M4915

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M4915 Issued in ID

Practice address

2705 E 17TH St
Ammon, ID 83406-6601

Phone

(208) 346-7500

Fax

(208) 346-7501

NPI assigned

Mar 15, 2007

Last updated

Apr 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Internal Medicine

Education

Hahneman Medical College of the Pacific, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pearl Health ClinicGroup PAC ID 0840356077, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pearl Health Clinic

  • Mental Health Counselor
  • Ammon, ID
  • NPI 1447426465
  Medicare reassignment Care Compare group NPD
• Family Care Center, Inc

  dba A New Life Counseling

  • Professional Counselor
  • Idaho Falls, ID
  • NPI 1205863222
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1336273085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066601",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066601",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENAGY",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "M4915",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M4915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002648500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "49155",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "G526301",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "C36950",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010005201",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "1370128",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "820428306",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassie Davis
• Clarence Davis, LSW
• Joshua G Davis, O.D.
• Pamela Davis, CPSS
• Delayna Day
• Jodi Lynn Dennett
• Mark D Denney, OD
• Lance Denning, PHARMD
• Amy Lynn Diaz, CBRS, CASE MANAGER
• Spencer Louis Dietz, PHARMD, RPH

• Internal Medicine Physician in Ammon, ID
• Providers in Ammon, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.