Active NPI
Marcus D Neff, DDS
- General Practice Dentistry
- Pocatello, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D3710
- Practice address
- 1000 N 8TH Ave
Pocatello, ID 83201-5757 - Phone
- (208) 232-3368
- Fax
- (208) 776-5016
- NPI assigned
- Aug 9, 2006
- Last updated
- Mar 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D3710 | ID | Primary |
Addresses
Primary practice location
1000 N 8TH Ave
Pocatello, ID 83201-5757
Mailing address
1000 N 8TH Ave
Pocatello, ID 83201-5757
Phone (208) 232-3368
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952316341 | Other | ID | NPI FOR BUSINESS |
| 806687200 | Medicaid | ID |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151208001861 | ID | Order and Referring Only - Dentist | 8820398209 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3710 | ID | MD | General Practice Dentistry |
Ownership & related parties
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Health West Pocatello | Federally qualified health center | Corporate Director W-2 Managing Employee |
Jun 30, 2014 Jun 30, 2014 |
| Health West Lava | Federally qualified health center | Corporate Director W-2 Managing Employee |
Jun 30, 2014 Jun 30, 2014 |
| Health West American Falls | Federally qualified health center | Corporate Director W-2 Managing Employee |
Jun 30, 2014 Jun 30, 2014 |
| Health West Family Medicine Clinic | Federally qualified health center | Corporate Director W-2 Managing Employee |
Jun 30, 2014 Jun 30, 2014 |
| Health West Inc | Federally qualified health center | Corporate Director W-2 Managing Employee |
Jun 30, 2014 Jun 30, 2014 |
Owned or controlled facilities with NPI records 5
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Health West Pocatello Clinic
- Federally Qualified Health Center (FQHC)
- Pocatello, ID
- NPI 1154320752
Corporate Director, W-2 Managing Employee
-
dba Health West Lava Clinic
- Federally Qualified Health Center (FQHC)
- Lava Hot Springs, ID
- NPI 1427057926
Corporate Director, W-2 Managing Employee
-
dba Health West American Falls Clinic
- Federally Qualified Health Center (FQHC)
- American Falls, ID
- NPI 1629077235
Corporate Director, W-2 Managing Employee
-
dba Health West Chubbuck Clinic
- Federally Qualified Health Center (FQHC)
- Chubbuck, ID
- NPI 1629499751
Corporate Director, W-2 Managing Employee
-
dba Health West ISU
- Federally Qualified Health Center (FQHC)
- Pocatello, ID
- NPI 1912261413
Corporate Director, W-2 Managing Employee
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489104000000",
"number": "1811907744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N 8TH AVE",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015757",
"telephone_number": "208-232-3368",
"fax_number": "208-776-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N 8TH AVE",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015757",
"telephone_number": "208-232-3368",
"fax_number": "208-776-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEFF",
"first_name": "MARCUS",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2017-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D3710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI FOR BUSINESS",
"identifier": "1952316341",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806687200",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.