| Ronald K Ellsworth, MD | |
|
402 Lake Cascade Pkwy, Cascade, ID 83611-7702 | |
| (208) 382-4242 | |
| (208) 382-5081 |
| Full Name | Ronald K Ellsworth |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 16 Years |
| Location | 402 Lake Cascade Pkwy, Cascade, 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 |
|---|---|---|---|
| 1245556141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-11978 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Home Care And Hospice | Meridian, ID | Home health agency |
| Cascade Medical Center | Cascade, ID | Hospital |
| St Luke's Mccall | Mccall, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cascade Medical Center Hospital District | 6103739719 | 13 |
| Entity Name | Cascade Medical Center Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003988825 PECOS PAC ID: 6103739719 Enrollment ID: O20040309001351 |
| Entity Name | Shoshone Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043215437 PECOS PAC ID: 6103739107 Enrollment ID: O20050113001084 |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald K Ellsworth, MD Po Box 1330, Cascade, ID 83611-1330 Ph: (208) 382-4242 | Ronald K Ellsworth, MD 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 Ph: (208) 382-4242 |
Dr. Bradley Wade Gilman, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 402 Old State Hwy, Cascade, ID 83611 Phone: 208-382-4242 Fax: 208-382-3580 |