Unknown Individual – Cardiovascular Disease Physician, NPI 1477578300
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
South Woodruff Avenue, Idaho Falls, Bonneville County, Idaho, 83401, United States
IDAHO FALLS, ID 834046371
Phone: (208) 523-3050
Fax: (208) 523-4985
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 6 Open Payments records for all available years, with a total value of $962.
Total Amount is formed as General ($962) + Research ($0) + Ownership ($0) = $962.
Last reported payment date: 2023-11-27 • Largest payer in this snapshot: Merit Medical Systems Inc ($866).
Total Amount
$962
General + Research + Ownership
Payments
6
Total payment records
General Amount
$962
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merit Medical Systems Inc | $866 |
| Abbott Laboratories | $49 |
| Boston Scientific Corporation | $47 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 156 | 103 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 45 | 44 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 36 | 27 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 30 | 20 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 22 | 17 | $0 |
Insurance plans in this area (ZIP 83404)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | ID | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 243 | 239 |
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | ID | 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 29 | 29 |
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | ID | 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 46 | 34 |
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