Active NPI
Ananda Walaliyadda, M.D.
- Specialist
- Pocatello, ID
National Provider Identifier
1497747703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- M8731
- Practice address
- 1448 E Center St
Suite E
Pocatello, ID 83201-4132 - Phone
- (208) 234-1300
- Fax
- (208) 234-1333
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | M8731 | ID | Primary |
Addresses
Primary practice location
1448 E Center St
Suite E
Pocatello, ID 83201-4132
Mailing address
1448 E Center St
Suite E
Pocatello, ID 83201-4132
Phone (208) 234-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J9521 | Other | ID | BLUE CROSS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070622000444 | ID | Practitioner - Rheumatology | 9830298462 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arthritis Specialty Center,Inc
Practice addresses (Care Compare)
1448 E Ctr St
Suite E
Pocatello, ID 83201-4132
Phone (208) 234-1300
352 W Sunnyside Rd
Idaho Falls, ID 83402-4615
Phone (208) 234-1300
Hospital & facility affiliations
- Portneuf Medical Center
- Mountain View Hospital
- Eastern Idaho Regional Medical Center
- Bear Lake Memorial Hospital
- Madison Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.21 of 100
- Quality
- 82.55
- Promoting interoperability
- 97
- Improvement activities
- 40
- Cost
- 33.97
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8731 | ID | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arthritis Specialty Center,Inc | Specialist | Current | Accepting new patients |
Locations
352 W Sunnyside Rd
Idaho Falls, ID 83402
Phone (208) 234-1300
1448 E Center St
Ste E
Pocatello, ID 83201
Phone (208) 234-1300
711 Rigby Lake Dr
Ste 1400
Rigby, ID 83442
Phone (208) 234-1300
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BHFAAA
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 and National Provider Directory roles.
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1225082209
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1497747703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1448 E CENTER ST",
"address_2": "SUITE E",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014132",
"telephone_number": "208-234-1300",
"fax_number": "208-234-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1448 E CENTER ST",
"address_2": "SUITE E",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014132",
"telephone_number": "208-234-1300",
"fax_number": "208-234-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALALIYADDA",
"first_name": "ANANDA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ID",
"license": "M8731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J9521",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
- Laura Ann Wadsworth Lundquist, MSN, FNP-C, IBCLC
- Marissa Jacqueline Wagner Edmunds
- Kevin Joseph Wagner, DMD
- Christine F Waite, DPT
- Wal-Mart Stores, Inc
- Hemantha Naveen Walaliyadda, MD
- Praveen Anuradha Walaliyadda, MD
- Ranmali Kalyani Walaliyadda, PAC
- Stephanie Theresa Walbridge, MS, PA-C
- Sean Paul Waldron, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.