DR. GORDON SCOTT BONTRAGER (MD) – Family Medicine Physician, NPI 1780919829
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
969 FAMILY PRACTICE in ID
Provider Addresses for DR. GORDON SCOTT BONTRAGER (MD)
43 N 1ST E
PRESTON, ID 832631325
Phone: (208) 648-4771
Fax: (208) 744-0140
Type: Location
44 N 1st E
Preston, ID 832631326
Phone: (208) 648-4771
Type: Location
Family Medicine/Dental Sciences, 465, Memorial Drive, Pocatello, Bannock County, Idaho, 83201, United States
POCATELLO, ID 832014008
Phone: (208) 234-4700
Fax: (208) 282-4696
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Takeda Pharmaceuticals U.S.A., Inc. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Takeda Pharmaceuticals U.S.A., Inc. | $16 |
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: 2020-12-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201211001838 | I | Family Practice | ID | TBD |
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.
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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 55 | 29 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 45 | 31 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 34 | 34 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 83263)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ID |
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