NPIMap

Organization Active NPI

Paragon Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Idaho Falls, ID
National Provider Identifier
1831996545
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PARAGON ANESTHESIA LLC
Practice address
2001 S Woodruff Ave Ste 6
Idaho Falls, ID 83404-6371
Phone
(208) 715-8220
Fax
(208) 715-8221
NPI assigned
Feb 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Jaron Polatis, CRNANPI 1225676000
Title
Owner
Phone
(208) 709-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2001 S Woodruff Ave Ste 6
Idaho Falls, ID 83404-6371

Mailing address

PO Box 2523
Idaho Falls, ID 83403-2523
Phone (800) 338-5378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250904004733 ID Part B Supplier - Clinic/Group Practice 3274035720 Receives reassigned benefits from 3 practitioners
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1831996545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2523",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032523",
            "telephone_number": "800-338-5378",
            "fax_number": "208-523-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 6",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046371",
            "telephone_number": "208-715-8220",
            "fax_number": "208-715-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "POLATIS",
        "authorized_official_first_name": "JARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-709-6300",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.