Individual provider Active NPI

Richard M Natelson, MD

  • Obstetrics & Gynecology Physician
  • Salmon, ID
National Provider Identifier
1568588697
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-7890 Issued in ID
Practice address
805 Main St
Salmon, ID 83467-0000
Phone
(208) 756-6212
Fax
(208) 756-6336
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M7890 ID
Obstetrics & Gynecology Physician 207V00000X M-7890 ID Primary

Addresses

Primary practice location

805 Main St
Salmon, ID 83467-0000

Mailing address

203 S Daisy St
Salmon, ID 83467-0000
Phone (208) 756-5600

Other identifiers 1

IdentifierTypeStateIssuer
805613200MedicaidID

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716001032 ID Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 6608855218 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7890IDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Memorial Medical Center CurrentSince Dec 21, 1999 Accepting new patients
Steele Memorial Medical Center CurrentSince Dec 21, 1999 Accepting new patients
Steele Memorial Medical Center Past Accepting new patients
Steele Memorial Medical Center PastSince Nov 6, 2022 Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

805 Main St
Salmon, ID 83467
Phone (208) 282-3495

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1568588697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S DAISY ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834670000",
            "telephone_number": "208-756-5600",
            "fax_number": "208-756-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MAIN ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834670000",
            "telephone_number": "208-756-6212",
            "fax_number": "208-756-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATELSON",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M7890",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-7890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805613200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.