| Dr Michael D Severson, MD | |
|
520 S Eagle Rd, Suite 1222, Meridian, ID 83642-6351 | |
| (208) 947-2266 | |
| (208) 947-2267 |
| Full Name | Dr Michael D Severson |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 26 Years |
| Location | 520 S Eagle Rd, Meridian, 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 |
|---|---|---|---|
| 1205827904 | NPI | - | NPPES |
| P00036983 | Other | ID | RAILROAD MEDICARE |
| 806625400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | M8793 (Idaho) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | M8793 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| St Luke's Mccall | Mccall, ID | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 1062 |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael D Severson, MD 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Dr Michael D Severson, MD 520 S Eagle Rd, Suite 1222, Meridian, ID 83642-6351 Ph: (208) 947-2266 |
Anna Martsenyuk, APRN, ACNS-BC Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 2240 W Everest Ln Ste 150, Meridian, ID 83646 Phone: 208-505-4744 Fax: 844-402-0970 | |
Mr. Shane A Maxwell, D.O. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 3551 E Overland Rd, Meridian, ID 83642 Phone: 208-884-1333 Fax: 208-489-5188 |