JONATHAN WILLIAM ROZACK (FNP-C) – Family Nurse Practitioner, NPI 1255429288

JONATHAN WILLIAM ROZACK (FNP-C) is a healthcare provider. based in Idaho falls, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. NP525A (ID). The NPI Number for JONATHAN WILLIAM ROZACK (FNP-C) is 1255429288

Main info

Male
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN WILLIAM ROZACK (FNP-C)
NPI
1255429288
Phone
(208) 524-0133
Address
2775 CHANNING WAY
Enumeration Date
11 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085240133
Graduation Year
2001 (25 years ago)
PAC ID
9234433954
Group Practice PAC ID
9830501766
Professional Enrollment ID
I20210216002411
Address ID
ID834047510ID2775XWAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,798 NURSE PRACTITIONER in ID

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Provider Addresses for JONATHAN WILLIAM ROZACK (FNP-C)

  • 2775, Channing Way, Idaho Falls, Bonneville County, Idaho, 83404, United States

    IDAHO FALLS, ID 834047510

    Phone: (208) 524-0133

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 55 Open Payments records for all available years, with a total value of $1,040.

Total Amount is formed as General ($1,040) + Research ($0) + Ownership ($0) = $1,040.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($337).

Total Amount

$1,040

General + Research + Ownership

Payments

55

Total payment records

General Amount

$1,040

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210216002411INurse PractitionerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes10149$0
99214Established patient office or other outpatient visit, 30-39 minutes5740$0
36415Insertion of needle into vein for collection of blood sample4030$0
View full utilization report →

Insurance plans in this area (ZIP 83404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830501766View full group profile
NameSpecialtyState
Family PracticeUT
Family PracticeID
Family PracticeMA

Reviews

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Frequently asked questions

Is JONATHAN WILLIAM ROZACK (FNP-C) listed with a National Provider Identifier?
Yes — JONATHAN WILLIAM ROZACK (FNP-C) has NPI 1255429288 on file in the registry.
Active or inactive — what applies to JONATHAN WILLIAM ROZACK (FNP-C)?
You should see JONATHAN WILLIAM ROZACK (FNP-C) as active in CMS-hosted NPPES data.
What area of care is associated with JONATHAN WILLIAM ROZACK (FNP-C)?
JONATHAN WILLIAM ROZACK (FNP-C)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Idaho is JONATHAN WILLIAM ROZACK (FNP-C) registered?
Use Idaho Falls, Idaho as the headline location for JONATHAN WILLIAM ROZACK (FNP-C) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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