Jonathan Donald Fisher, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P-198 Issued in ID

Practice address

30544 Highway 200
Suite 102
Ponderay, ID 83852-5005

Phone

(208) 265-9817

Fax

(208) 265-4533

NPI assigned

Apr 14, 2008

Sex

Male

Sole proprietor

No

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.

• Michael R Dibenedetto MD PLLC

  • Orthopaedic Surgery Physician
  • Ponderay, ID
  • NPI 1083809727
  Medicare reassignment Care Compare group NPD ID
• Pend Oreille County Public Hospital District No 1

  • Emergency Medicine Physician
  • Newport, WA
  • NPI 1427264795
  Medicare reassignment Care Compare group NPD WA
• Pend Oreille County Public Hospital District No 1

  • Critical Access Hospital
  • Newport, WA
  • NPI 1780778423
  Medicare reassignment Care Compare group NPD WA
• Pend Oreille County Public Hospital District No 1

  • Community/Retail Pharmacy
  • Newport, WA
  • NPI 1134831415
  Care Compare group NPD
• Pend Oreille County Public Hospital District No 1

  • Rural Health Clinic/Center
  • Newport, WA
  • NPI 1912026360
  Care Compare group NPD (past)
• Pend Oreille County Public Hospital District No 1

  • Medicare Defined Swing Bed Hospital Unit
  • Newport, WA
  • NPI 1326113366
  Care Compare group
• Pend Oreille County Public Hospital District No 1

  • Clinic/Center
  • Newport, WA
  • NPI 1720294002
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bonner General Hospital Inc.

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  Care Compare affiliation Hospital
• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Care Compare affiliation Hospital
• Pend Oreille County Public Hospital District No 1

  • Critical Access Hospital
  • Newport, WA
  • NPI 1780778423
  Care Compare affiliation Hospital

Specialty

Podiatry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael R Dibenedetto MD PLLC 8 clinicians

Pend Oreille County Public Hospital District No 1 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newport Community Hospital Hospital, Newport, WA, CCN 501310
• Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
• Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jon.fisher@nioasm-id.direct.office.nextgen.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2021.

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1891969606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30544 HIGHWAY 200",
            "address_2": "SUITE 102",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838525005",
            "telephone_number": "208-265-9817",
            "fax_number": "208-265-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30544 HIGHWAY 200",
            "address_2": "SUITE 102",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838525005",
            "telephone_number": "208-265-9817",
            "fax_number": "208-265-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JONATHAN",
        "middle_name": "DONALD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P-198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P2448",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808011000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1100300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010167109",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00638389",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. Paul E. Koch, Optometrist, P.C
• Eden Home Health of Sandpoint, LLC
• Eden Hospice at the Inland Northwest, LLC
• Arleen Mae Erland
• Ew Anesthesia PLLC
• Samantha Ann Fisher, RD, LD
• Thomas G Fletcher, M.D.
• Foster Holdings LTD
• Kathy Gavin, FNP
• Glacier Prosthetic Care, Inc.

• All providers in Ponderay, ID
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.