Active NPI
Susan M Marzolf, M.D.
- Obstetrics & Gynecology Physician
- Twin Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- M-7035
- Practice address
- 801 Pole Line Rd W Ste 3880
Twin Falls, ID 83301-5811 - Phone
- (208) 814-8500
- NPI assigned
- Dec 7, 2005
- Last updated
- Oct 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 33703 | AZ | |
| Obstetrics & Gynecology Physician | 207V00000X | M-7035 | ID | Primary |
Addresses
Primary practice location
801 Pole Line Rd W Ste 3880
Twin Falls, ID 83301-5811
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86080015085259C424 | Other | AZ | TRIWEST |
| P00251227 | Other | AZ | RAILROAD MEDICARE |
| 916455 | Medicaid | AZ |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33703 | AZ | MD | Obstetrics & Gynecology Physician |
| M-7035 | ID | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| St Luke's Clinic LLC | Current | Accepting new patients | |
| St Luke's Magic Valley Regional Medical Center LTD | Past | Accepting new patients |
Locations
100 E Idaho St
Ste 400
Boise, ID 83712
Phone (208) 345-5250
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000
520 S Eagle Rd
Ste 3209
Meridian, ID 83642
Phone (208) 345-5250
746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230
801 Pole Line Rd W
Ste 3880
Twin Falls, ID 83301
Phone (208) 814-8500
Interoperability endpoints
- smarzolf295120@direct.ochin.org
- smarzolf31972@direct.slhs.org
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.
-
dba St Lukes Clinic - Magic Valley/Jerome
- Family Medicine Physician
- Twin Falls, ID
- NPI 1790718229
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
Obstetrics & Gynecology
-
dba St Lukes RHC - Trinity Mountain
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
-
dba St Lukes Retail Pharmacy Twin Falls
- Community/Retail Pharmacy
- Twin Falls, ID
- NPI 1760203921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1568447019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 POLE LINE RD W STE 3880",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015811",
"telephone_number": "208-814-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARZOLF",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-07",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AZ",
"license": "33703",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "ID",
"license": "M-7035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "86080015085259C424",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00251227",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "916455",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.