Anesthesia Associates of Coeur D Alene PLLC
Organization Active NPI Anesthesiology Physician · Coeur D Alene, ID
NPI 1962440966 · NPPES record last updated Aug 31, 2023
Key facts
- NPI
- 1962440966
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- ANESTHESIA ASSOCIATES OF COEUR D ALENE PLLC
- Practice address
- 101 W Ironwood Dr Ste 250
Coeur D Alene, ID 83814-1415 - Phone
- (208) 765-8585
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Erik J Payne, M.D.
- Title
- Member
- Phone
- (208) 771-3722
Practitioners 80
-
Erik J Payne, M.D.
-
Stephen F Ayers, CRNA
-
Scott Daniel Bode, M.D.
-
Mark F Brinkman, M.D.
-
Marin Selene Cordova, CRNA
-
Jonathan David Debooy, M.D.
-
Samuel Hayward Ellison, CRNA
-
Trenton James Evans, CRNA
-
Megan Louise Feist, CRNA
-
Sara Elizabeth Fennell, CRNA
-
Brian D Fuller, CRNA
-
Gary B Glenn, CRNA
-
Marcus Eugene Harrell, CRNA
-
Chelsea Faye Hubbard, CRNA
-
Fred Jowdy, CRNA
-
Kevin Kerschner, RN
-
Joshua Leppert, CRNA
-
Jason D Marshall, CRNA
-
Nuria M Martinez, CRNA
-
Melissa Mazzola, CRNA
-
Michelene Morin, CRNA
-
Sarah Nelson, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040621000475 | ID | Part B Supplier - Clinic/Group Practice | 2365427838 |
Receives reassigned benefits from 79 practitioners Practice locations: Coeur D Alene, ID |
National Provider Directory
Locations
101 W Ironwood Dr
Ste 250
Coeur D Alene, ID 83814
Phone (208) 765-8585
1814 Lincoln Way
Coeur D Alene, ID 83814
Phone (208) 667-2531
212 W Ironwood Dr
Ste D
Coeur D Alene, ID 83814
Phone (208) 755-3237
2204 N Ironwood Pl
Ste B
Coeur D Alene, ID 83814
Phone (208) 765-8585
707 W Ironwood Dr
Coeur D Alene, ID 83814
Phone (208) 625-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
101 W Ironwood Dr Ste 250
Coeur D Alene, ID 83814-1415
Mailing address
PO Box 35145 #40023
Seattle, WA 98124-5145
Phone (425) 407-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010017887 | Other | ID | REGENCE B/S GROUP NUMBER |
| CE9560 | Other | ID | RR MEDICARE GRP NUMBER |
| 8B016 | Other | ID | BLUE CROSS IDAHO GROUP # |
Other providers in Coeur D Alene, ID
- Sharon L Anderson
- Skyler Lee Anderson
- Jeremy E Andres
- Donna Louise Andrews
- Melissa Androsov
- Genita Angel
- Miranda Anspach
- Vanessa Renee Anstine
- Barbara Aparicio
- Maria Isabel Aparicio
All providers in Coeur D Alene, ID · Anesthesiology Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.