Roger H Tall, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

M4222 Issued in ID

Practice address

2001 S Woodruff
Suite 8
Idaho Falls, ID 83404

Phone

(208) 529-0633

Fax

(208) 529-1948

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1972604494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF",
            "address_2": "SUITE 8",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-0633",
            "fax_number": "208-529-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF",
            "address_2": "SUITE 8",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-0633",
            "fax_number": "208-529-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALL",
        "first_name": "ROGER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M4222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1912238544",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972604494",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradford L Talcott, M.D.
• Tall Family Physical Therapy PLLC
• Jacob Tall
• Mark Asael Tall, DDS
• Michael Aldon Tall, D.D.S.
• Tambree Meadows Assisted Living
• Steven Adam Tank, MD
• Matt Tannenbaum, MD
• Nicholas J Tanner, D.D.S.
• Shahzaib Tariq, MD

• Urology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Urology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.