Idaho Sports & Spine Pllc - Medicare Primary Care in Pocatello, ID

Idaho Sports & Spine Pllc is a medicare enrolled primary clinic (Family Medicine - Sports Medicine) in Pocatello, Idaho. The current practice location for Idaho Sports & Spine Pllc is 950 Hospital Way, Ste A, Pocatello, Idaho. For appointments, you can reach them via phone at (208) 478-4522. The mailing address for Idaho Sports & Spine Pllc is 950 Hospital Way, Ste A, Pocatello, Idaho and phone number is (208) 478-4522.

Idaho Sports & Spine Pllc is licensed to practice in Idaho (license number O-0400). The clinic also participates in the medicare program and its NPI number is 1033417035. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (208) 478-4522.

Contact Information

Idaho Sports & Spine Pllc
950 Hospital Way
Ste A
Pocatello
ID 83201-2789
(208) 478-4522
(208) 478-2935

Primary Care Clinic Profile

Full NameIdaho Sports & Spine Pllc
SpecialityFamily Medicine
Location950 Hospital Way, Pocatello, Idaho
Authorized Official Name and PositionStephen Hansen (OWNER)
Authorized Official Contact2084784522
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Idaho Sports & Spine Pllc
950 Hospital Way
Ste A
Pocatello
ID 83201-2789

Ph: (208) 478-4522
Idaho Sports & Spine Pllc
950 Hospital Way
Ste A
Pocatello
ID 83201-2789

Ph: (208) 478-4522

NPI Details:

NPI Number1033417035
Provider Enumeration Date03/01/2011
Last Update Date11/04/2019

Medicare PECOS Information:

Medicare PECOS PAC ID8426234345
Medicare Enrollment IDO20110510000817

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› Verified 4 days ago

Medical Identifiers

Medical identifiers for Idaho Sports & Spine Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033417035NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QS0010XFamily Medicine - Sports Medicine O-0400 (Idaho)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Idaho Sports & Spine Pllc acts as a billing entity for following providers:
Provider NameStephen M Hansen
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1164491460
PECOS PAC ID: 9739149709
Enrollment ID: I20121220000238

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› Verified 4 days ago

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› Verified 4 days ago


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