Ridgeline Medical Llc is a medicare enrolled "Family Medicine" provider in Idaho Falls, Idaho. Their current practice location is
2470 Jafer Ct, Idaho Falls, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 715-9990.
Ridgeline Medical Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ridgeline Medical Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1386110963.
Healthcare Provider's Profile
Full Name | Ridgeline Medical Llc |
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Type | Facility |
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Speciality | Family Medicine |
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Location | 2470 Jafer Ct, Idaho Falls, Idaho |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1386110963
- Provider Enumeration Date: 10/22/2018
- Last Update Date: 11/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 5092054551
- Enrollment ID: O20190227001380
Medical Identifiers
Medical identifiers for Ridgeline Medical Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1386110963 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207QS1201X | Family Medicine - Sleep Medicine | (* (Not Available)) | Secondary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ridgeline Medical Llc acts as a billing entity for following providers:
Provider Name | Christina M Finnerty |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1558430918 PECOS PAC ID: 1850352568 Enrollment ID: I20041025001046 |
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Provider Name | Martin A Mangan |
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Provider Type | Practitioner - Family Practice |
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Provider Identifiers | NPI Number: 1972709103 PECOS PAC ID: 6709937758 Enrollment ID: I20090702000185 |
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Provider Name | Jeffrey C Haskell |
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Provider Type | Practitioner - Family Practice |
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Provider Identifiers | NPI Number: 1073535506 PECOS PAC ID: 6709067135 Enrollment ID: I20110218000114 |
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Provider Name | Kathryn Roth |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1467893289 PECOS PAC ID: 0446572788 Enrollment ID: I20141124000574 |
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Provider Name | Danny E Spencer |
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Provider Type | Practitioner - Emergency Medicine |
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Provider Identifiers | NPI Number: 1508890682 PECOS PAC ID: 3375714744 Enrollment ID: I20181015003568 |
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Provider Name | Analee S Fish |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1407405111 PECOS PAC ID: 0143657841 Enrollment ID: I20200302001391 |
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Provider Name | Robert Grondel |
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Provider Type | Practitioner - Orthopedic Surgery |
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Provider Identifiers | NPI Number: 1124037650 PECOS PAC ID: 7012907512 Enrollment ID: I20220518001725 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ridgeline Medical Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ridgeline Medical Llc 2429 Jafer Ct, Idaho Falls, ID 83404-5587 Ph: (208) 715-9990 | Ridgeline Medical Llc 2470 Jafer Ct, Idaho Falls, ID 83404-5587 Ph: (208) 715-9990 |
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