| Dr Christopher James Malcom, DO | |
|
4519 Enterprise Way, Caldwell, ID 83605-8055 | |
| (208) 455-7482 | |
| (208) 455-7538 |
| Full Name | Dr Christopher James Malcom |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 17 Years |
| Location | 4519 Enterprise Way, Caldwell, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447402425 | NPI | - | NPPES |
| 817783 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | O-0744 (Idaho) | Primary |
| 2085B0100X | Radiology - Body Imaging | O-0744 (Idaho) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eastern Idaho Regional Medical Center | Idaho falls, ID | Hospital |
| Portneuf Medical Center | Pocatello, ID | Hospital |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| Sagewest Health Care | Riverton, WY | Hospital |
| Star Valley Medical Center | Afton, WY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Teton Radiology Diagnostic A Series Of Teton Group Enterprise | 1254436959 | 37 |
| Teton Radiology Caldwell | 2365892742 | 18 |
| Cache Valley Vein | 5294069563 | 19 |
| Teton Radiology Madison Llc | 6901958024 | 33 |
| Medical Imaging Associates Of Idaho Falls Inc | 7618876590 | 51 |
| Teton Radiology Diagnostic A Series Of Teton Group Enterprise | 1254436959 | 37 |
| Teton Radiology Caldwell | 2365892742 | 18 |
| Cache Valley Vein | 5294069563 | 19 |
| Teton Radiology Madison Llc | 6901958024 | 33 |
| Teton Radiology Diagnostic A Series Of Teton Group Enterprise | 1254436959 | 37 |
| Teton Radiology Caldwell | 2365892742 | 18 |
| Cache Valley Vein | 5294069563 | 19 |
| Teton Radiology Madison Llc | 6901958024 | 33 |
| Entity Name | Medical Imaging Associates Of Idaho Falls Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740225531 PECOS PAC ID: 7618876590 Enrollment ID: O20040108000883 |
| Entity Name | Boise Advanced Imaging Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013946235 PECOS PAC ID: 1850346180 Enrollment ID: O20050318000643 |
| Entity Name | Teton Radiology Diagnostic A Series Of Teton Group Enterprise |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013085604 PECOS PAC ID: 1254436959 Enrollment ID: O20070424000540 |
| Entity Name | Teton Radiology Madison Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407081060 PECOS PAC ID: 6901958024 Enrollment ID: O20090720000575 |
| Entity Name | Teton Vascular Institute Of Pocatello A Series Of Teton Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508224379 PECOS PAC ID: 8921306846 Enrollment ID: O20160409000003 |
| Entity Name | Innovative Medical Imaging Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962015776 PECOS PAC ID: 1951711050 Enrollment ID: O20201030001557 |
| Entity Name | Cache Valley Vein |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831662311 PECOS PAC ID: 5294069563 Enrollment ID: O20231106001459 |
| Entity Name | Teton Radiology Caldwell |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336920420 PECOS PAC ID: 2365892742 Enrollment ID: O20240320000965 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Christopher James Malcom, DO 4519 Enterprise Way, Caldwell, ID 83605-8055 Ph: (208) 455-7482 | Dr Christopher James Malcom, DO 4519 Enterprise Way, Caldwell, ID 83605-8055 Ph: (208) 455-7482 |
Loreli Smith, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-455-3730 | |
Randy L James, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-455-3730 | |
Dr. Daniel S Graves, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-455-3732 |