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
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

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

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
PA-1667OtherIDIDAHO STATE PA LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 23, 2025.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE PA LICENSE",
            "identifier": "PA-1667",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.