NPIMap

Individual provider Active NPI

Joseph R Liljenquist, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Idaho Falls, ID
National Provider Identifier
1558375568
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
M9781 Issued in ID
Practice address
2210 Coronado St
Idaho Falls, ID 83404
Phone
(208) 522-3355
Fax
(208) 522-6019
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 3587652 OH
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X M9781 ID Primary

Addresses

Primary practice location

2210 Coronado St
Idaho Falls, ID 83404

Mailing address

2210 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-3355

Other identifiers 1

IdentifierTypeStateIssuer
807709400MedicaidID

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
I20071116000439 ID Practitioner - Orthopedic Surgery 0840298097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
George Washington University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Idaho Orthopaedics PLLCGroup PAC ID 2860783834, 6 clinicians

Practice addresses (Care Compare)

2210 Coronado St
Idaho Falls, ID 83404-7552
Phone (208) 522-3355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.19 of 100Reported as individual
Quality
75.55
Promoting interoperability
100
Improvement activities
40
Cost
65.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement20
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9781IDMDSports Medicine (Orthopaedic Surgery) Physician
3587652OHMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Idaho Orthopaedics, PLLC Orthopaedic Surgery CurrentSince Nov 16, 2007 Accepting new patients
Mountain Land Rehabilitation LLC CurrentSince May 24, 2025 Accepting new patients
East Idaho Orthopaedics PLLC Orthopaedic Surgery Past Accepting new patients

Locations

2210 Coronado St
Idaho Falls, ID 83404
Phone (208) 317-3956

3405 Merlin Dr
Idaho Falls, ID 83404
Phone (208) 522-3355

Interoperability endpoints

  • Direct secure messaging: joseph.liljenquist.1@14639.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14639/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1558375568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILJENQUIST",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "3587652",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "ID",
            "license": "M9781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807709400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.