| Dr Jeremy Robert Nicolarsen, MD | |
|
2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | |
| (208) 625-4000 | |
| Not Available |
| Full Name | Dr Jeremy Robert Nicolarsen |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 19 Years |
| Location | 2003 Kootenai Health Way, Coeur D Alene, 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 |
|---|---|---|---|
| 1891946778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0202X | Pediatrics - Pediatric Cardiology | M13579 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Prov Sacred Hrt Med Ctr & Childs Hosp. | Spokane, WA | Hospital |
| St. Patrick Hospital | Missoula, MT | Hospital |
| Providence Holy Family Hospital | Spokane, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Health And Services Washington | 0345139929 | 727 |
| Providence Health And Services Washington | 8729258256 | 52 |
| Providence Health And Services Washington | 0345139929 | 727 |
| Providence Health And Services Mt | 6608786306 | 293 |
| Entity Name | Providence Health & Services Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194099390 PECOS PAC ID: 0345139929 Enrollment ID: O20040311001453 |
| Entity Name | Providence Health & Services Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881907715 PECOS PAC ID: 8729258256 Enrollment ID: O20110819000034 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeremy Robert Nicolarsen, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-4000 | Dr Jeremy Robert Nicolarsen, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-4000 |
Dr. Thomas R Rau, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Dr. Sarah Renee Claussen, D.O. Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5187 Fax: 208-625-6892 | |
Terence Earl Neff, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 | |
Bryan Jonathan Furr, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5187 | |
Dr. Brook Yuknis Lang, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5185 Fax: 208-625-5892 | |
Dr. Timothy Joseph Gay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-6446 | |
Dr. Mary Jo Shaw, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876 |