Individual provider Active NPI

Mark Jonathan Mosemann, M.D.

  • Emergency Medicine Physician
  • Rathdrum, ID
National Provider Identifier
1861473639
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MC-2296 Issued in ID
Practice address
15622 N Highway 41
Rathdrum, ID 83858-8710
Phone
(208) 687-4878
Fax
(208) 687-4879
NPI assigned
Nov 9, 2005
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MC-2296 ID Primary

Addresses

Primary practice location

15622 N Highway 41
Rathdrum, ID 83858-8710

Mailing address

15622 N Highway 41
Rathdrum, ID 83858-8710
Phone (208) 687-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040518001088 WY Practitioner - Emergency MedicinePractitioner - Family Practice 9830180041 Reassigns benefits to 2 organizations
I20230919003477 ID Practitioner - Emergency Medicine 9830180041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1593 E Polston Ave
Post Falls, ID 83854-5326

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MC-2296IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Sep 25, 2023 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Memorial Hospital of Converse County PastSince Sep 1, 2023 Accepting new patients

Locations

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

15622 N Highway 41
Rathdrum, ID 83858
Phone (208) 687-4878

2100 W Sunset Dr
Riverton, WY 82501
Phone (307) 856-4161

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1861473639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15622 N HIGHWAY 41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838588710",
            "telephone_number": "208-687-4878",
            "fax_number": "208-687-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15622 N HIGHWAY 41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838588710",
            "telephone_number": "208-687-4878",
            "fax_number": "208-687-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSEMANN",
        "first_name": "MARK",
        "middle_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "MC-2296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rathdrum, ID

Sources for this page

Verify at the official NPI Registry.