Individual provider Active NPI

Luisa A. Hiendlmayr, M.D.

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1730474602
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-14769 Issued in ID
Practice address
2775 Channing Way
Idaho Falls, ID 83404-7510
Phone
(208) 524-0133
NPI assigned
Jun 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-14769 ID Primary

Addresses

Primary practice location

2775 Channing Way
Idaho Falls, ID 83404-7510

Mailing address

2775 Channing Way
Idaho Falls, ID 83404-7510
Phone (208) 524-0133

Other names 1

  • Luisa A Pineda Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427000170 ID Practitioner - Family Practice 1254563372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Council of Idaho, Inc.Group PAC ID 6204877467, 18 clinicians
Eric Bennett PLLCGroup PAC ID 9830501766, 5 clinicians

Practice addresses (Care Compare)

2088 E 25TH St
Idaho Falls, ID 83404-6490

2100 Alan St
Idaho Falls, ID 83404-5801
Phone (208) 528-7655

2775 Channing Way
Idaho Falls, ID 83404-7510
Phone (208) 524-0133

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Bennett PLLC Family Medicine CurrentSince Apr 20, 2022 Accepting new patients
Community Council of Idaho, Inc Family Medicine Current Accepting new patients
Community Council of Idaho, Inc. Family Medicine CurrentSince May 19, 2024 Accepting new patients
Community Council of Idaho, Inc. Family Medicine Past Accepting new patients
Southeast Idaho Family Practice Family Medicine Past Accepting new patients

Locations

1491 Parkway Dr
Blackfoot, ID 83221
Phone (208) 435-2379

2100 Alan St
Idaho Falls, ID 83404
Phone (208) 470-7979

2775 Channing Way
Idaho Falls, ID 83404
Phone (208) 524-0133

4002 E 397 N
Ste 3
Rigby, ID 83442
Phone (208) 228-2200

Interoperability endpoints

  • Direct secure messaging: luisa.hiendlmayr.1@16437.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1730474602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047510",
            "telephone_number": "208-524-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047510",
            "telephone_number": "208-524-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIENDLMAYR",
        "first_name": "LUISA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-14769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUISA",
            "last_name": "PINEDA",
            "middle_name": "A",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.