Brian E O'Byrne, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M6123 Issued in ID

Practice address

2860 Channing Way
Ste 117
Idaho Falls, ID 83404-7532

Phone

(208) 523-2470

Fax

(208) 523-1118

NPI assigned

Jul 21, 2005

Reactivated

Apr 6, 2006

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

Other identifiers 1

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

Specialty

General Surgery

Education

Jefferson Medical College of Thomas Jefferson University, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Brian E O'Byrne, M.D. P.a.

  • Surgery Physician
  • Idaho Falls, ID
  • NPI 1790012383
  Medicare reassignment NPD Authorized official
• Pathology Associates of Idaho Falls P a

  • Anatomic Pathology & Clinical Pathology Physician
  • Idaho Falls, ID
  • NPI 1497723241
  NPD (past)

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

• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1801896717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY",
            "address_2": "STE 117",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047532",
            "telephone_number": "208-535-4470",
            "fax_number": "208-535-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY",
            "address_2": "STE 117",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047532",
            "telephone_number": "208-523-2470",
            "fax_number": "208-523-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BYRNE",
        "first_name": "BRIAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2010-12-22",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M6123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000084200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nurse Practitioners Care LLC
• Nurture Lactation Support for Women & Infants
• Nurturing Connections Therapeutic Services LLC
• Gjori Nykreim
• Patrick J O'Bannon
• John Patrick O'Neal, LCPC
• Luke William O'Rourke, D.O.
• Alicia Oakes, LMSW
• Abigail Oakley, LCPC
• Oakstead Infusion Pharmacy of Idaho, LLC (Vital Care of Eastern Idaho)

• Surgery Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.