Lyle Jeremy Jackson, CRNA in Idaho Falls, ID - Medicare Certified Registered Nurse Anesthetist (crna)

Lyle Jeremy Jackson, CRNA is a medicare enrolled "Registered Nurse - Orthopedic" in Idaho Falls, Idaho. He graduated from nursing school in 2019 and has 6 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Mountain View Hospital Llc, Iceland Anesthesia Management Llc, Clinical Colleagues Inc, North Iowa Mercy Clinics and his current practice location is 2325 Coronado St, Idaho Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 557-2700.

Lyle Jeremy Jackson is licensed to practice in Idaho (license number 62439) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1225597305.

Contact Information

	Lyle Jeremy Jackson, CRNA
	2325 Coronado St, Idaho Falls, ID 83404-7407
	(208) 557-2700
	Not Available

Map and Direction

Provider's Profile

Full Name	Lyle Jeremy Jackson
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	6 Years
Location	2325 Coronado St, Idaho Falls, Idaho
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lyle Jeremy Jackson graduated from nursing school in 2019

NPI Data:

NPI Number: 1225597305
Provider Enumeration Date: 03/18/2019
Last Update Date: 06/30/2025

Medicare PECOS Information:

PECOS PAC ID: 9931434586
Enrollment ID: I20210422003117

Medical Identifiers

Medical identifiers for Lyle Jeremy Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225597305	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	125895 (Virginia)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	D183481 (Iowa)	Secondary
163WX0800X	Registered Nurse - Orthopedic	62439 (Idaho)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mountain View Hospital	Idaho falls, ID	Hospital
Union Hospital Inc	Terre haute, IN	Hospital
Mercyone North Iowa Medical Center	Mason city, IA	Hospital
Idaho Falls Community Hospital, Llc	Idaho falls, ID	Hospital
Memorial Hospital	Logansport, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mountain View Hospital Llc	4486562774	248
Iceland Anesthesia Management Llc	7618372996	55
Clinical Colleagues Inc	8729011333	148
North Iowa Mercy Clinics	7810809076	273

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lyle Jeremy Jackson allows following entities to bill medicare on his behalf.

Entity Name	Mountain View Hospital Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lyle Jeremy Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lyle Jeremy Jackson, CRNA 1090 Barney Dairy Rd, Rexburg, ID 83440-3542 Ph: (801) 319-9345	Lyle Jeremy Jackson, CRNA 2325 Coronado St, Idaho Falls, ID 83404-7407 Ph: (208) 557-2700

Reviews and Comments

Registered Nurse Nurses in Idaho Falls, ID

Melissa Gallant, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402 Phone: 208-528-5700 Fax: 208-528-5747
Alexis R Siddoway, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-535-4432
Casey Joseph Short, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2325 Coronado St, Idaho Falls, ID 83404 Phone: 208-557-2700
Mrs. Jessica Munson Steiner, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 675 E Anderson St, Idaho Falls, ID 83401 Phone: 208-432-1976 Fax: 208-278-7956
Christine Barber, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-604-6605
Jaxon Dean Anderson, CRNA Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 2325 Coronado St, Idaho Falls, ID 83404 Phone: 208-557-2700
James Taylor Barnes, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1415 Whitewater Dr Apt 2104, Idaho Falls, ID 83402 Phone: 801-710-3525

Lyle Jeremy Jackson, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Idaho Falls, ID