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Individual provider Active NPI

John Urrutia, P.A.C

  • Medical Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1831290097
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA336 Issued in ID
Practice address
176 Falls Avenue
Twin Falls, ID 83301
Phone
(208) 733-3181
Fax
(208) 733-3168
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA336 ID Primary

Addresses

Primary practice location

176 Falls Avenue
Twin Falls, ID 83301

Mailing address

176 Falls Avenue
Twin Falls, ID 83301
Phone (208) 733-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040218001039 ID Practitioner - Physician Assistant 0941113278 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sipi Clinic LLC 6 clinicians
St Lukes Clinic LLC 313 clinicians

Practice addresses (Care Compare)

176 Falls Ave
Twin Falls, ID 83301-2306
Phone (208) 733-3181

228 Shoup Ave W
Twin Falls, ID 83301-5022
Phone (208) 814-7900

746 N College Rd
Twin Falls, ID 83301-3486

Hospital & facility affiliations

  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA336IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation CurrentSince Sep 10, 2007 Accepting new patients
Family Health Services Corporation Medical CurrentSince Sep 10, 2007 Accepting new patients
Family Health Services Corporation Past Accepting new patients
Magic Valley Surgery Clinic, PA Past Accepting new patients
Family Health Services Pharmacy Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Past Accepting new patients

Locations

725 Fair St
Buhl, ID 83316
Phone (208) 543-8271

1309 Bennett Ave
Burley, ID 83318
Phone (208) 677-5198

218 W Nez Perce
Jerome, ID 83338
Phone (208) 324-3471

402 6th St
Rupert, ID 83350
Phone (208) 650-7941

113 S Apple St
Shoshone, ID 83352
Phone (208) 886-2224

388 Martin St
Twin Falls, ID 83301
Phone (208) 734-0451

794 Eastland Dr
Twin Falls, ID 83301
Phone (208) 734-3312

325 Martin St
Twin Falls, ID 83301
Phone (208) 732-7101

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1831290097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 FALLS AVENUE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 FALLS AVENUE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-3181",
            "fax_number": "208-733-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URRUTIA",
        "first_name": "JOHN",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.