Robert Todd Gillespie, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA205 Issued in ID

Practice address

220 Bannock St
Suite B
Malad City, ID 83252-1256

Phone

(208) 766-2600

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMH IncGroup PAC ID 8426149758, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Symbii Home Health Home health agency, Chubbuck, ID, CCN 137110
• Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: r.gillespie@bmh.medalliesdirect.net

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.

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271

  ID

  Medicare reassignment Care Compare group NPD
• BMH, Inc.

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193

  ID

  Medicare reassignment Care Compare group
• BMH Inc.

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1770785875
  Care Compare group NPD (past)
• BMH Inc

  • Rural Health Clinic/Center
  • Shelley, ID
  • NPI 1366630949
  Care Compare group
• BMH Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Blackfoot, ID
  • NPI 1689876781
  Care Compare group
• BMH Inc

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1922243088
  Care Compare group
• BMH Inc.

  • Skilled Nursing Facility
  • Blackfoot, ID
  • NPI 1861694960
  Care Compare group
• BMH Inc

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1174091896

  Family Medicine

  NPD
• BMH, Inc.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995

  Family Medicine

  NPD
• Safe Haven Health Care LLC

  • Psychiatric Hospital
  • Pocatello, ID
  • NPI 1619208709
  NPD (past)

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

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271

  Hospital

  Care Compare affiliation
• Whitewater Healthcare LLC

  • Home Health Agency
  • Chubbuck, ID
  • NPI 1477177921
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1922026467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "address_2": "SUITE B",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832520126",
            "telephone_number": "208-766-2231",
            "fax_number": "208-766-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BANNOCK ST",
            "address_2": "SUITE B",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832521256",
            "telephone_number": "208-766-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805203600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "970011284",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyson Daniels, LCSW
• Lisa Davis, RDN
• Alexa Edwards, LMSW
• Jennifer Felter, NP
• Seth Adam Fesler, LMT
• Catherine M. Harmston, FNP
• Amy Kathleen Hawkins, ATC
• Robert David Hodson, D.O.
• Hypt LLC
• Idaho Spine Clinic LLC

• All providers in Malad City, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.