Active NPI
Catalyst Medical Group, PLLC
- Multi-Specialty Clinic/Center
- Lewiston, ID
National Provider Identifier
1912458787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- CATALYST MEDICAL GROUP, PLLC
- Practice address
- 2315 8TH St
Lewiston, ID 83501 - Phone
- (208) 746-1383
- Fax
- (208) 746-6348
- NPI assigned
- Oct 17, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karl E Sundberg
- Title
- Ceo
- Phone
- (208) 746-1383
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
2315 8TH St
Lewiston, ID 83501
Mailing address
2315 8TH St
Lewiston, ID 83501-7301
Phone (208) 746-1383
Other practice location 1
320 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 746-8741
Other practice location 2
1174 Alturas Dr
Moscow, ID 83843-8341
Phone (208) 743-3523
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912458787 | Medicaid | WA | |
| 1912458787 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, ID
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
2216 Vineyard Ave
Lewiston, ID 83501
Phone (208) 289-0425
320 Warner Dr
Ste 100
Lewiston, ID 83501
2315 8th St
Ste 100
Lewiston, ID 83501
1174 Alturas Dr
Ste 3
Moscow, ID 83843
Phone (208) 473-3523
831 Ash St University Of Idaho
Moscow, ID 83844
Phone (208) 885-6693
808 Port Dr
Clarkston, WA 99403
Phone (208) 746-1383
1225 Highland Ave
Clarkston, WA 99403
Phone (509) 758-4652
Interoperability endpoints
- tflock@cmgadmin.directmessaging.net
- gdietrich@cmgadmin.directmessaging.net
- kthueson@cmgadmin.directmessaging.net
- dweaver@cmgadmin.directmessaging.net
- sboyea@cmgadmin.directmessaging.net
- rhansen@cmgadmin.directmessaging.net
- cklemens@cmgadmin.directmessaging.net
- jjelinek@cmgadmin.directmessaging.net
- bpaulson@cmgadmin.directmessaging.net
- rmorton@cmgadmin.directmessaging.net
- bbeardsley@cmgadmin.directmessaging.net
- gobray@cmgadmin.directmessaging.net
Practitioners & affiliated clinicians
Practitioners 60
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Lewiston, ID
- NPI 1932159258
-
- Physician Assistant
- Lewiston, ID
- NPI 1710756325
-
- Orthopaedic Foot and Ankle Surgery Physician
- Lewiston, ID
- NPI 1639516255
WA
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Lewiston, ID
- NPI 1568410025
WA
-
- Family Nurse Practitioner
- Lewiston, ID
- NPI 1316776727
-
- Pediatrics Physician
- Lewiston, ID
- NPI 1396828158
-
- Physician Assistant
- Lewiston, ID
- NPI 1245798719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680220800000",
"number": "1912458787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 8TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835017301",
"telephone_number": "208-746-1383",
"fax_number": "208-746-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 8TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "83501",
"telephone_number": "208-746-1383",
"fax_number": "208-746-6348"
}
],
"practiceLocations": [
{
"address_1": "320 Warner Dr",
"address_purpose": "LOCATION",
"city": "Lewiston",
"state": "ID",
"postal_code": "835014441",
"country_code": "US",
"telephone_number": "208-746-8741",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1174 Alturas Dr",
"address_purpose": "LOCATION",
"city": "Moscow",
"state": "ID",
"postal_code": "838438341",
"country_code": "US",
"telephone_number": "208-743-3523",
"fax_number": "208-746-8741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CATALYST MEDICAL GROUP, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-17",
"last_updated": "2023-03-31",
"certification_date": "2023-03-31",
"status": "A",
"authorized_official_last_name": "SUNDBERG",
"authorized_official_first_name": "KARL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "208-746-1383"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912458787",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912458787",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.