NPIMap

Individual provider Active NPI

Andrew Mazzone, M.D.

  • Urology Physician
  • Twin Falls, ID
National Provider Identifier
1619402286
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-16761 Issued in ID
Practice address
775 Pole Line Rd W Ste 301
Twin Falls, ID 83301-5823
Phone
(208) 814-8700
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 114025 MT
Urology Physician 208800000X M-16761 ID Primary
Urology Physician 208800000X 10959125-1205 UT
Urology Physician 208800000X 25185 NV

Addresses

Primary practice location

775 Pole Line Rd W Ste 301
Twin Falls, ID 83301-5823

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

5560 Kietzke Ln Bldg A
Reno, NV 89511-3019
Phone (775) 322-7811

Other practice location 2

5070 Ion Dr Ste 201
Sparks, NV 89436-1612
Phone (775) 322-7811

Other practice location 3

University Of Utah Som Division Of Urology
30 North 1900 East
Salt Lake City, UT 84132-0001
Phone (801) 213-2780

Other practice location 4

1401 25th St S
Great Falls, MT 59405-5183
Phone (406) 731-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WY, NV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220913003937 MT Practitioner - Urology 2264785575 Reassigns benefits to 1 organization
I20240510002513 WY Practitioner - Urology 2264785575 Reassigns benefits to 1 organization
I20240528003641 NV Practitioner - Urology 2264785575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rush Medical College of Rush University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Nevada LTDGroup PAC ID 1557460557, 24 clinicians

Practice addresses (Care Compare)

5560 Kietzke LN
BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.04 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
72.37

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114025MTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Sweetwater County CurrentSince May 1, 2024 Accepting new patients
Urology Nevada LTD Urology CurrentSince Jul 1, 2024 Accepting new patients
Memorial Hospital of Sweetwater County CurrentSince May 1, 2024 Accepting new patients
Benefis Hospitals Inc CurrentSince Aug 30, 2022 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients

Locations

1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

10745 Double R Blvd
Reno, NV 89521
Phone (775) 322-7811

5560 Kietzke Ln
Bldg A
Reno, NV 89511
Phone (775) 322-7811

5560 Kietzke Ln
Reno, NV 89511
Phone (775) 284-1612

5070 Ion Dr
Ste 201
Sparks, NV 89436
Phone (775) 322-7811

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

1180 College Dr
Rock Springs, WY 82901
Phone (307) 352-8125

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19482/brand/1/csg/1/fhir/r4
  • Direct secure messaging: andrew.mazzone.1@19482.direct.athenahealth.com
  • Direct secure messaging: amazzone738166@direct.med.utah.edu

Organizations & group practices 7

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1619402286",
    "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": "775 POLE LINE RD W STE 301",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015823",
            "telephone_number": "208-814-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5560 Kietzke Ln Bldg A",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895113019",
            "country_code": "US",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5070 Ion Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894361612",
            "country_code": "US",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "University Of Utah Som Division Of Urology",
            "address_2": "30 North 1900 East",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-213-2780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 25th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055183",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZZONE",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "114025",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M-16761",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "10959125-1205",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NV",
            "license": "25185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.