Matthew Scott Lidstrom, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

M-14997 Issued in ID

Practice address

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Phone

(208) 625-6300

Fax

(208) 625-6301

NPI assigned

Jun 15, 2012

Last updated

Feb 18, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Diagnostic Radiology

Education

Yale University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Radiology Associates of North Idaho PAGroup PAC ID 4385635150, 32 clinicians

Benewah Community HospitalGroup PAC ID 1850200700, shared by 2 NPIs, 39 clinicians

Bonner General Hospital IncGroup PAC ID 4082690466, 47 clinicians

Boundary Community HospitalGroup PAC ID 3274583406, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
• Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317
• Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.223001
• FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/
• FHIR API: https://fhir-myrecord.cerner.com/r4/e8b4f872-6ea1-4b26-a974-041b5fb4c57b/

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.

• Bonner General Hospital Inc.

  dba Bonner General Health

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  Medicare reassignment Care Compare group NPD
• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Medicare reassignment Care Compare group NPD
• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur d'Alene, ID
  • NPI 1174661151
  Medicare reassignment Care Compare group NPD
• Radiology Associates of North Idaho, PA

  dba Kootenai Imaging

  • Radiology Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1851384416

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Benewah Community Hospital

  dba St Maries Family Medicine

  • Rural Health Clinic/Center
  • St Maries, ID
  • NPI 1386632180

  Internal Medicine

  Medicare reassignment NPD
• Benewah Community Hospital

  • Critical Access Hospital
  • St Maries, ID
  • NPI 1548320435

  Diagnostic Radiology

  Medicare reassignment NPD
• Kootenai Health, Inc.

  dba Kootenai Medical Center Group

  • Emergency Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1235288655
  Medicare reassignment NPD
• Shoshone Medical Center

  • Critical Access Hospital
  • Kellogg, ID
  • NPI 1043215437
  Medicare reassignment NPD
• Bonner General Hospital, Inc.

  dba Bonner General Family and Internal Medicine

  • Family Medicine Physician
  • Sandpoint, ID
  • NPI 1033737887

  Internal Medicine

  NPD
• Boundary Community Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bonners Ferry, ID
  • NPI 1679621098

  Diagnostic Radiology

  NPD
• Boundary Community Hospital

  dba Boundary Community Clinics

  • Rural Health Clinic/Center
  • Bonners Ferry, ID
  • NPI 1801273552
  NPD
• Kootenai Health, Inc.

  dba Kootenai Health Pharmacy

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benewah Community Hospital

  • Critical Access Hospital
  • St Maries, ID
  • NPI 1548320435
  Care Compare affiliation
• Bonner General Hospital Inc.

  dba Bonner General Health

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  Care Compare affiliation
• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Care Compare affiliation
• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  dba Northwest Specialty Hospital

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1447512348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6309",
            "fax_number": "208-625-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6300",
            "fax_number": "208-625-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-6360",
            "fax_number": "208-625-6361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Jacobs Gulch Rd",
            "address_purpose": "LOCATION",
            "city": "Kellogg",
            "state": "ID",
            "postal_code": "838372023",
            "country_code": "US",
            "telephone_number": "208-784-1221",
            "fax_number": "208-784-0961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDSTROM",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-14997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlidstrom627550@direct.multicare.org",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr Ste 175",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Brittany Lewis, LCSW
• Carl E Ley, MD
• LF3
• LHCG Xxi, LLC (North Idaho Home Health)
• Liberty Services, LLC
• Jeff E Lien, PA
• Lifecare Solutions Inc
• Lifehouse Healthcare PLLC (Lifehouse Healthcare)
• Amanda Rose Liggett, M.D.
• Lincare Inc.

• Diagnostic Radiology Physician in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.