Individual provider Active NPI

Naglaa Bargelski

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1669940110
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1667 Issued in ID
Practice address
2375 E Sunnyside Rd Ste I
Idaho Falls, ID 83404-8281
Phone
(208) 535-4300
NPI assigned
Nov 2, 2018
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1667 ID Primary

Addresses

Primary practice location

2375 E Sunnyside Rd Ste I
Idaho Falls, ID 83404-8281

Mailing address

2375 E Sunnyside Rd Ste I
Idaho Falls, ID 83404-8281
Phone (208) 569-4510

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190108002520 ID Practitioner - Physician Assistant 1052657301 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-1667IDMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1669940110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE I",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-569-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE I",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-535-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGELSKI",
        "first_name": "NAGLAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.