NPIMap

Individual provider Active NPI

Richard Alan Nathan, D.O.

  • Infectious Disease Physician
  • Idaho Falls, ID
National Provider Identifier
1942229570
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
O-301 Issued in ID
Practice address
3614 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone
(208) 535-8400
Fax
(208) 535-8409
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X O-301 ID Primary

Addresses

Primary practice location

3614 Washington Pkwy
Idaho Falls, ID 83404-7573

Mailing address

3614 Washington Pkwy
Idaho Falls, ID 83404-7573
Phone (208) 535-8400

Other identifiers 1

IdentifierTypeStateIssuer
806522000MedicaidID

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
I20071211000689 ID Practitioner - Infectious DiseasePractitioner - Internal Medicine 1850315078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Idaho Falls Infectious Diseases, PLLCGroup PAC ID 9032133251, 2 clinicians

Practice addresses (Care Compare)

2900 Cortez Ave
Idaho Falls, ID 83404-7554
Phone (208) 535-8400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Falls Infectious Diseases, PLLC Infectious Disease CurrentSince Dec 7, 2002 Accepting new patients

Locations

2900 Cortez Ave
Idaho Falls, ID 83404
Phone (208) 523-3857

3614 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 535-4343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16744/brand/1/csg/1/fhir/r4
  • Direct secure messaging: richard.nathan.1@16744.direct.athenahealth.com

Organizations & group practices 1

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 7

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1942229570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-535-8400",
            "fax_number": "208-535-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047573",
            "telephone_number": "208-535-8400",
            "fax_number": "208-535-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "ID",
            "license": "O-301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806522000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.