Individual provider Active NPI

Michael K. James, DPM

  • Podiatrist
  • Idaho Falls, ID
National Provider Identifier
1629111497
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P140-7 Issued in ID
Practice address
3345 S Holmes Ave
Idaho Falls, ID 83404-7981
Phone
(208) 528-6225
Fax
(208) 528-8022
NPI assigned
Feb 14, 2007
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P140-7 ID Primary

Addresses

Primary practice location

3345 S Holmes Ave
Idaho Falls, ID 83404-7981

Mailing address

3345 S Holmes Ave
Idaho Falls, ID 83404-7981
Phone (208) 528-6225

Other identifiers 4

IdentifierTypeStateIssuer
1629111497OtherNPI
P140-7OtherIDBLUE CROSS
001310400MedicaidID
000010015609OtherIDBLUE SHIELD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000533 ID Practitioner - Podiatry 8022911023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Teton Foot and Ankle Center, PCGroup PAC ID 1658525696, 2 clinicians

Practice addresses (Care Compare)

3345 S Holmes Ave
Idaho Falls, ID 83404-7981
Phone (208) 528-6225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue33
Removal of skin lesions19
Removal of nail tissue97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P140-7IDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Surgery Center, LLC CurrentSince Mar 31, 2004 Accepting new patients
Alpine Anesthesia LLC CurrentSince Aug 4, 2024 Accepting new patients
Teton Foot & Ankle Center, PC Podiatrist CurrentSince Jun 6, 2012 Accepting new patients
Brent Blue MD Past Accepting new patients

Locations

3345 S Holmes Ave
Idaho Falls, ID 83404
Phone (208) 525-6225

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.

Hospital & facility affiliations 1

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1629111497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047981",
            "telephone_number": "208-528-6225",
            "fax_number": "208-528-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047981",
            "telephone_number": "208-528-6225",
            "fax_number": "208-528-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "MICHAEL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ID",
            "license": "P140-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629111497",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P140-7",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001310400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010015609",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.