Individual provider Active NPI

Peter L Vance, MD

  • Diagnostic Radiology Physician
  • Idaho Falls, ID
National Provider Identifier
1619056199
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M8158 Issued in ID
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 529-6111
NPI assigned
Nov 3, 2006
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M8158 ID Primary

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

2265 E Sunnyside Rd
Idaho Falls, ID 83404-7598
Phone (208) 542-5000

Other identifiers 2

IdentifierTypeStateIssuer
806336100MedicaidID
300131798OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, MT, WY, UT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050331000481 ID Practitioner - Diagnostic Radiology 0446207690 Reassigns benefits to 6 organizations
I20081230000089 MT Practitioner - Diagnostic Radiology 0446207690 Reassigns benefits to 6 organizations
I20120330000265 WY Practitioner - Diagnostic Radiology 0446207690 Reassigns benefits to 8 organizations
I20231128001212 UT Practitioner - Diagnostic Radiology 0446207690 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wake Forest University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Teton Radiology CaldwellGroup PAC ID 2365892742, 16 clinicians
Cache Valley VeinGroup PAC ID 5294069563, 36 clinicians
Teton Radiology Madison LLCGroup PAC ID 6901958024, 40 clinicians
Memorial Hospital of Carbon CountyGroup PAC ID 9638067176, shared by 3 NPIs, 38 clinicians

Practice addresses (Care Compare)

110 Hospital LN
Afton, WY 83110-9409
Phone (208) 454-0742

1100 Hollenbeck LN
Deer Lodge, MT 59722-2317
Phone (208) 522-3017

2001 S Woodruff Ave
Idaho Falls, ID 83404-6371
Phone (435) 753-2842

2001 S Woodruff Ave
Suite 17
Idaho Falls, ID 83404-6372
Phone (208) 524-7237

2100 W Sunset Dr
Riverton, WY 82501-2274
Phone (208) 522-3017

2221 Elm St
Rawlins, WY 82301-5108
Phone (307) 324-2221

300 3Rd St
Rawlins, WY 82301-5612
Phone (307) 324-8494

310 N Sansome St
Philipsburg, MT 59858-7554
Phone (208) 715-5220

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 715-5220

393 E 2ND
Rexburg, ID 83440-1605

425 E 4TH
Rexburg, ID 83440-5390
Phone (208) 356-4888

450 E Main St
Reburg, ID 83440-2048

4519 Enterprise Way
Caldwell, ID 83605-8055
Phone (208) 454-0742

565 W 465
Suite 130
Providence, UT 84332-4802
Phone (435) 753-2842

901 Adams St
Afton, WY 83110-9621
Phone (208) 715-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.36 of 100Reported as group
Quality
74.54
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
69.87
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
86.33
Improvement activities
40
Cost
88.62

Merit-based Incentive Payment System (MIPS)

Final score
33.71 of 100Reported as group
Quality
39.66
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8158IDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teton Radiology Diagnostic a Series of Teton Group Enterprise Diagnostic Radiology CurrentSince Jan 1, 2007 Accepting new patients
Elevation Medical Imaging Evanston CurrentSince May 1, 2024 Accepting new patients
Teton Radiology Diagnostic, LLC Current Accepting new patients
Memorial Hospital of Carbon County CurrentSince Oct 17, 2020 Accepting new patients
Teton Radiology Caldwell Diagnostic Radiology CurrentSince Nov 12, 2023 Accepting new patients
State of Montana CurrentSince Nov 12, 2019 Accepting new patients
Teton Radiology Madison LLC CurrentSince Jul 1, 2009 Accepting new patients
Memorial Hospital of Carbon County CurrentSince Oct 17, 2020 Accepting new patients
Teton Vascular Institute of Pocatello a Series of Teton Group CurrentSince Sep 16, 2023 Accepting new patients
Memorial Hospital of Carbon County Family Medicine Current Accepting new patients
Memorial Hospital of Carbon County Current Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Diagnostic Radiology CurrentSince Jul 1, 2002 Accepting new patients
Cache Valley Vein CurrentSince Aug 22, 2023 Accepting new patients
Medical Imaging Assoc of Idaho Falls, PA PastSince Jun 26, 2022 Accepting new patients
Advanced Diagnostic Radiology PC Diagnostic Radiology Past Accepting new patients

Locations (25 of 47)

510 Roosevelt St
American Fls, ID 83211
Phone (208) 226-2327

1441 Parkway Dr
Blackfoot, ID 83221
Phone (208) 785-2600

1441 Parkway Dr
Rm T9
Blackfoot, ID 83221
Phone (208) 785-2600

350 N Meridian St
Blackfoot, ID 83221
Phone (208) 782-0300

98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763

4519 Enterprise Way
Caldwell, ID 83605
Phone (208) 454-4960

120 E Howard St
Driggs, ID 83422
Phone (208) 354-2302

1957 E 17th St
Idaho Falls, ID 83404
Phone (208) 523-1100

2001 S Woodruff Ave
Idaho Falls, ID 83404
Phone (208) 523-2060

2001 S Woodruff Ave
Ste 17
Idaho Falls, ID 83404
Phone (208) 524-7237

2001 S Woodruff Ave
Ste 20
Idaho Falls, ID 83404
Phone (208) 525-3201

2235 E 25th St
Idaho Falls, ID 83404
Phone (208) 522-9812

2265 E Sunnyside Rd
Idaho Falls, ID 83404

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221

150 N 200 W
Malad City, ID 83252
Phone (208) 766-2231

164 S 5th St
Montpelier, ID 83254
Phone (208) 847-1630

1151 Hospital Way
Pocatello, ID 83201
Phone (208) 233-3353

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

444 Hospital Way
Ste 111
Pocatello, ID 83201

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 6

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1619056199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 E SUNNYSIDE RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047598",
            "telephone_number": "208-542-5000",
            "fax_number": "208-542-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-529-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "PETER",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M8158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806336100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300131798",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.