Active NPI
Lucas Webb, DO
- Pediatric Anesthesiology Physician
- Idaho Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 0-1020
- Practice address
- 3100 Channing Way
Idaho Falls, ID 83404-7533 - Phone
- (208) 529-6111
- NPI assigned
- May 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Anesthesiology Physician | 207LP3000X | 0-1020 | ID | Primary |
Addresses
Primary practice location
3100 Channing Way
Idaho Falls, ID 83404-7533
Mailing address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111
Other practice location 1
11234 Anderson St
GME Office CSP 21005
Loma Linda, CA 92354-2804
Phone (909) 558-4015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111
Hospital & facility affiliations
- Eastern Idaho Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-1020 | ID | MD | Pediatric Anesthesiology Physician |
| 13110 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KND Development 59, LLC | Current | Accepting new patients | |
| KND Development 59, LLC | Current | Accepting new patients | |
| Intermountain Anesthesia, PA | Current | Accepting new patients | |
| KND Development 59 LLC | Current | Accepting new patients |
Locations
550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290
3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Idaho Falls, ID
- NPI 1558304329
-
- Hospitalist Physician
- Santa Ana, CA
- NPI 1740519081
-
- Hospitalist Physician
- Ontario, CA
- NPI 1497084792
-
- Hospitalist Physician
- Broken Arrow, OK
- NPI 1922950823
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1225082209
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1689933384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 CHANNING WAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047533",
"telephone_number": "208-529-6111"
},
{
"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": [
{
"address_1": "11234 Anderson St",
"address_2": "GME Office CSP 21005",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-4015",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEBB",
"first_name": "LUCAS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-15",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "ID",
"license": "0-1020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.