Active NPI
Scott Burgstahler, M.D.
- Internal Medicine Physician
- Sandpoint, ID
National Provider Identifier
1871547323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- M5470
- Practice address
- 207 Church St
Sandpoint, ID 83864-1342 - Phone
- (208) 263-6876
- Fax
- (208) 263-2033
- NPI assigned
- May 20, 2006
- Last updated
- Aug 20, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M5470 | ID | Primary |
Addresses
Primary practice location
207 Church St
Sandpoint, ID 83864-1342
Mailing address
PO Box 2153 Dept 40339
Birmingham, AL 35287-9387
Phone (706) 271-0100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010003647 | Other | ID | PIN |
| 003603300 | Medicaid | ID | |
| 54700 | Other | ID | PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5470 | ID | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Health PLLC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Sandpoint, ID
- NPI 1487380655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1871547323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2153 DEPT 40339",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352879387",
"telephone_number": "706-271-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 CHURCH ST",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641342",
"telephone_number": "208-263-6876",
"fax_number": "208-263-2033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGSTAHLER",
"first_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ID",
"license": "M5470",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN",
"identifier": "000010003647",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003603300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN",
"identifier": "54700",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.