| Dr Derek Thomas Dirks, MD | |
|
750 N Syringa St Ste 205, Post Falls, ID 83854-5275 | |
| (208) 262-0945 | |
| (208) 415-0150 |
| Full Name | Dr Derek Thomas Dirks |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 11 Years |
| Location | 750 N Syringa St Ste 205, Post Falls, 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 |
|---|---|---|---|
| 1427476225 | NPI | - | NPPES |
| 2136241 | Medicaid | WA | |
| 1427476225 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD193751 (Oregon) | Secondary |
| 208600000X | Surgery | M-15190 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Idaho Day Surgery Llc | 0840101218 | 76 |
| Kootenai Health Inc | 1355792276 | 382 |
| Entity Name | Kootenai Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230 |
| Entity Name | North Idaho Day Surgery Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104824739 PECOS PAC ID: 0840101218 Enrollment ID: O20110401000539 |
| Entity Name | Kootenai Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Derek Thomas Dirks, MD 1593 E Polston Ave, Post Falls, ID 83854-5326 Ph: (208) 262-0945 | Dr Derek Thomas Dirks, MD 750 N Syringa St Ste 205, Post Falls, ID 83854-5275 Ph: (208) 262-0945 |
John L Pennings, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 750 N Syringa St, Ste 205, Post Falls, ID 83854 Phone: 208-262-0945 Fax: 208-415-0150 | |
Antoine Y Sarkis, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 750 N Syringa St Ste 103, Post Falls, ID 83854 Phone: 208-415-0151 Fax: 208-777-1591 | |
Olga Ivanovna Lebedevskiy, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 750 N Syringa St Ste 205, Post Falls, ID 83854 Phone: 208-262-0945 Fax: 208-415-0150 | |
Dr. John Christopher Stackow, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1551 E Mullan Ave Ste 102, Post Falls, ID 83854 Phone: 208-262-2328 Fax: 208-619-5057 |