Kody Kurtis Tew, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-1057 Issued in ID

Practice address

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

Phone

(208) 528-7655

Fax

(208) 524-9390

NPI assigned

Mar 18, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Simpson Dermcare and Family Medicine PLLCGroup PAC ID 1355656307, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Simpson Dermcare and Family Medicine PLLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1174919534
  Medicare reassignment Care Compare group
• MVH BMC LLC

  • Family Medicine Physician
  • Blackfoot, ID
  • NPI 1649699174
  Medicare reassignment
• Upper Valley Family Medicine PLLC

  • Family Medicine Physician
  • Rigby, ID
  • NPI 1073697884
  Medicare reassignment
• MVH BMC LLC

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1467816579

  Family Medicine

  NPD
• MVH BMC LLC

  • Family Medicine Physician
  • Rexburg, ID
  • NPI 1649699216
  NPD
• Community Council of Idaho, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rigby, ID
  • NPI 1710664834

  Family Medicine

  NPD (past)
• Community Council of Idaho, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rigby, ID
  • NPI 1740356633

  Family Medicine

  NPD (past)
• New Dawn Counseling, LLC

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1912182163
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1760724744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046490",
            "telephone_number": "208-528-7655",
            "fax_number": "208-524-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046490",
            "telephone_number": "208-528-7655",
            "fax_number": "208-524-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEW",
        "first_name": "KODY",
        "middle_name": "KURTIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teton Surgical Specialties PLLC
• Teton Women'S Health Center
• Alisha Michelle Tew, CMA, CNA, PA
• Dustin Ferrel Tew, D.O.
• Joshua Gerald Tew, PA-C
• The Aspen Group, Inc.
• The Children'S Center
• The Counseling Agency
• The Evangelical Lutheran Good Samaritan Society
• The Evangelical Lutheran Good Samaritan Society

• Medical Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.

Verify at the official NPI Registry.