NPIMap

Individual provider Active NPI

Bryant Vanleeuwen, MD

  • Urology Physician
  • Pocatello, ID
National Provider Identifier
1891280442
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-17410 Issued in ID
Practice address
777 Hospital Way Ste 215
Pocatello, ID 83201-5175
Phone
(208) 239-2770
NPI assigned
Jun 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 8354 NE
Urology Physician 208800000X M-17410 ID Primary

Addresses

Primary practice location

777 Hospital Way Ste 215
Pocatello, ID 83201-5175

Mailing address

777 Hospital Way Ste 215
Pocatello, ID 83201-5175
Phone (208) 239-2770

Other practice location 1

1224 8th St
Rupert, ID 83350-1599
Phone (208) 436-0481

Other practice location 2

1218 9th St Ste 10
Rupert, ID 83350-2207
Phone (208) 436-8340

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
I20230922002386 ID Practitioner - Urology 9739533837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection24
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8354NEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Health Services, LLC CurrentSince Aug 9, 2023 Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients
Minidoka Memorial Hospital CurrentSince Jun 16, 2025 Accepting new patients
Minidoka Memorial Hospital CurrentSince Jun 16, 2025 Accepting new patients
Pocatello Health Services, LLC CurrentSince Aug 9, 2023 Accepting new patients
Minidoka Memorial Hospital Past Accepting new patients
Pocatello Hospital LLC Past Accepting new patients

Locations

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Ste 215
Pocatello, ID 83201
Phone (208) 239-2580

1218 9th St
Ste 10
Rupert, ID 83350
Phone (208) 434-8420

1224 8th St
Rupert, ID 83350
Phone (208) 434-8236

Interoperability endpoints

  • Direct secure messaging: bvanleeuwen882407@ahs.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1891280442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY STE 215",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY STE 215",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 8th St",
            "address_purpose": "LOCATION",
            "city": "Rupert",
            "state": "ID",
            "postal_code": "833501599",
            "country_code": "US",
            "telephone_number": "208-436-0481",
            "fax_number": "208-436-6038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1218 9th St Ste 10",
            "address_purpose": "LOCATION",
            "city": "Rupert",
            "state": "ID",
            "postal_code": "833502207",
            "country_code": "US",
            "telephone_number": "208-436-8340",
            "fax_number": "208-436-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANLEEUWEN",
        "first_name": "BRYANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "8354",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M-17410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.