Individual provider Active NPI

Alisa Vineyard, AU.D.

  • Audiologist
  • Pocatello, ID
National Provider Identifier
1538548839
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
2350 Via Caporatti Dr
Suite B
Pocatello, ID 83201-5095
Phone
(208) 237-5322
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X ID Primary

Addresses

Primary practice location

2350 Via Caporatti Dr
Suite B
Pocatello, ID 83201-5095

Mailing address

2350 Via Caporatti Dr
Suite B
Pocatello, ID 83201-5095
Phone (208) 237-5322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028001991 ID Practitioner - Qualified Audiologist 5991187718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Health Services, LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince Sep 1, 2022 Accepting new patients
Pocatello Health Services, LLC CurrentSince Sep 1, 2022 Accepting new patients
Pocatello Hospital LLC Internal Medicine Current Accepting new patients
Mirza Hearing Idaho Inc Past Accepting new patients
Dulcet Hearing, LLC Audiologist PastSince Jan 3, 2021 Accepting new patients

Locations

777 Hospital Way
Ste G15
Pocatello, ID 83201
Phone (208) 239-2260

777 Hospital Way
#G15
Pocatello, ID 83201
Phone (208) 239-2722

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1538548839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 VIA CAPORATTI DR",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015095",
            "telephone_number": "208-237-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 VIA CAPORATTI DR",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015095",
            "telephone_number": "208-237-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINEYARD",
        "first_name": "ALISA",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.