NPIMap

Individual provider Active NPI

Travis Lee Page, D.O.

  • Family Medicine Physician
  • Caldwell, ID
National Provider Identifier
1396760385
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-345 Issued in ID
Practice address
2523 S 10TH Ave Ste 103
Caldwell, ID 83605-6760
Phone
(208) 459-7788
Fax
(208) 455-3277
NPI assigned
Jul 12, 2006
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-345 ID Primary

Addresses

Primary practice location

2523 S 10TH Ave Ste 103
Caldwell, ID 83605-6760

Mailing address

3131 Shay Way
Nyssa, OR 97913-5052
Phone (541) 212-2305

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
I20151106000877 ID Practitioner - General PracticePractitioner - Other (Physician) 5193727956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caldwell Immediate CareGroup PAC ID 3678881893, 3 clinicians

Practice addresses (Care Compare)

2523 S 10TH Ave
Suite 103
Caldwell, ID 83605-6760
Phone (208) 459-7788

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-345IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care of Twin Falls PA Family Medicine CurrentSince Oct 14, 2015 Accepting new patients
Caldwell Immediate Care CurrentSince Sep 1, 2015 Accepting new patients
Page Family Medicine Family Medicine Past Accepting new patients
XL Hospice Inc Past Accepting new patients

Locations

2523 S 10th Ave
Ste 103
Caldwell, ID 83605
Phone (208) 459-7788

243 Cheney Dr W
#200
Twin Falls, ID 83301
Phone (208) 647-0656

260 Falls Ave
Ste C
Twin Falls, ID 83301
Phone (208) 329-8762

Organizations & group practices 4

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 12

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1396760385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 SHAY WAY",
            "city": "NYSSA",
            "state": "OR",
            "postal_code": "979135052",
            "telephone_number": "541-212-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 S 10TH AVE STE 103",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056760",
            "telephone_number": "208-459-7788",
            "fax_number": "208-455-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "TRAVIS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.