Northwest Gastroenterology, PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

M-11559 Issued in ID

Legal business name

NORTHWEST GASTROENTEROLOGY, PLLC

Practice address

526 Shoup Ave W
Twin Falls, ID 83301-6050

Phone

(208) 736-7620

Fax

(855) 830-4058

NPI assigned

Dec 26, 2017

Last updated

Jun 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judith Erika Csanky, MDNPI 1598843039

Title

Sole Owner

Phone

(503) 505-3628

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20656/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Judith Erika Csanky, MD

  • Gastroenterology Physician
  • Twin Falls, ID
  • NPI 1598843039
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1881100097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 EAGLECREST DR",
            "city": "FILER",
            "state": "ID",
            "postal_code": "833285068",
            "telephone_number": "503-505-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016050",
            "telephone_number": "208-736-7620",
            "fax_number": "855-830-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "CSANKY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ERIKA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "503-505-3628",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M-11559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Gastroenterology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.