Gary Earl Ellwein, MD in Idaho Falls, ID - Medicare Pathology

Gary Earl Ellwein, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Idaho Falls, Idaho. His current practice location is 3100 Channing Way, Idaho Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 529-6050.

Gary Earl Ellwein is licensed to practice in Idaho (license number M3265) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063480804.

Contact Information

	Gary Earl Ellwein, MD
	3100 Channing Way, Idaho Falls, ID 83404-7533
	(208) 529-6050
	(208) 529-7085

Physician's Profile

Full Name	Gary Earl Ellwein
Gender	Male
Speciality	Pathology - Anatomic Pathology & Clinical Pathology
Location	3100 Channing Way, Idaho Falls, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063480804
Provider Enumeration Date: 03/09/2006
Last Update Date: 12/27/2012

Medicare PECOS Information:

PECOS PAC ID: 5799874988
Enrollment ID: I20160425000763

Medical Identifiers

Medical identifiers for Gary Earl Ellwein such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063480804	NPI	-	NPPES
003682000	Medicaid	ID
000010003940	Other	ID	REGENCE BLUE SHIELD OF ID
32625	Other	ID	BLUE CROSS OF IDAHO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207ZP0102X	Pathology - Anatomic Pathology & Clinical Pathology	M3265 (Idaho)	Primary

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. Gary Earl Ellwein 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
Gary Earl Ellwein, MD 1820 E 17th St, Ste 230, Idaho Falls, ID 83404-6521 Ph: (208) 529-9779	Gary Earl Ellwein, MD 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (208) 529-6050

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Pathology Doctors in Idaho Falls, ID

Matt Tannenbaum, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085
Clark R Daines, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085
Floyd Joseph Fantelli, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085
Dr. Gabriele Emma Teermann, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6048 Fax: 208-529-7085

Gary Earl Ellwein, MD - Medicare Pathology in Idaho Falls, ID