| Mr Ryan Todd Porter, PA-C | |
|
98 Poplar St, Blackfoot, ID 83221-1758 | |
| (208) 785-4100 | |
| Not Available |
| Full Name | Mr Ryan Todd Porter |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 21 Years |
| Location | 98 Poplar St, Blackfoot, 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 |
|---|---|---|---|
| 1669556213 | NPI | - | NPPES |
| 4307719 | Medicaid | MT | |
| 808517600 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 447 (Montana) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | PA-827 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bingham Memorial Hospital | Blackfoot, ID | Hospital |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bmh Inc | 8426149758 | 124 |
| Bingham Memorial Hospital | 8426955014 | 67 |
| Entity Name | Bmh Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1982805271 PECOS PAC ID: 8426149758 Enrollment ID: O20070801000213 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Ryan Todd Porter, PA-C 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-4100 | Mr Ryan Todd Porter, PA-C 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-4100 |
John Todd Allen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Beverly Hanson, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-782-3993 Fax: 208-782-3994 | |
Shawna Marie Reynolds, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 Fax: 208-785-1762 | |
Scott Ryan Mangum, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
Heather Faye Grimmett, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Lucas P Belford, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Ryan Blair Killpack, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 |