Individual provider Active NPI

Tait Dell Olaveson, D.O.

  • Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1356518831
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
O-0726 Issued in ID
Practice address
3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546
Phone
(208) 529-2230
Fax
(208) 453-6142
NPI assigned
May 13, 2008
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X O-0726 ID
Surgery Physician 208600000X O-0726 ID Primary
Surgical Critical Care Physician 2086S0102X O-0726 ID

Addresses

Primary practice location

3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546

Mailing address

3200 Channing Way Ste A206
Idaho Falls, ID 83404-7586
Phone (208) 529-2230

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130927000464 ID Practitioner - General Surgery 2264610674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steele Lake Specialty PLLCGroup PAC ID 1153774567, 20 clinicians

Practice addresses (Care Compare)

3200 Channing Way
Suite A206
Idaho Falls, ID 83404-7586
Phone (208) 529-2230

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux16
Removal of tissue19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-0726IDMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
179881AKMDSurgery Physician
93936MTMDSurgery Physician
13411CWYMDSurgery Physician
4675OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Lake Specialty PLLC Surgery CurrentSince Mar 1, 2024 Accepting new patients

Locations

3200 Channing Way
Ste 206
Idaho Falls, ID 83404
Phone (208) 529-2230

3200 Channing Way
Ste A206
Idaho Falls, ID 83404
Phone (208) 529-2230

Organizations & group practices 1

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 2

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1356518831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE A206",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047586",
            "telephone_number": "208-529-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 206",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-529-2230",
            "fax_number": "208-453-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAVESON",
        "first_name": "TAIT",
        "middle_name": "DELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "ID",
            "license": "O-0726",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-0726",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "O-0726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.