Regenerize Psychiatry PLLC
NPI 1043054075 · Mental Health Clinic/Center (Including Community Mental Health Center) · Sandpoint, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Regenerize Psychiatry PLLC is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Sandpoint, ID (NPI 1043054075).
Provider details
- NPI number
- 1043054075
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Radley Peterson, Owner(208) 899-5997
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-06-24
- Last updated
- 2024-10-27
- Certified
- 2024-10-27
Frequently asked questions
- What is Regenerize Psychiatry PLLC's NPI number?
- Regenerize Psychiatry PLLC's National Provider Identifier (NPI) is 1043054075, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Regenerize Psychiatry PLLC?
- Regenerize Psychiatry PLLC is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Regenerize Psychiatry PLLC located?
- Regenerize Psychiatry PLLC's practice location on file with NPPES is 605 S Olive Ave, Sandpoint, ID 83864-1154.
- What is Regenerize Psychiatry PLLC's phone number?
- The practice phone number listed in the NPPES registry for Regenerize Psychiatry PLLC is (209) 677-7747.
- Does Regenerize Psychiatry PLLC accept Medicare?
- Regenerize Psychiatry PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Regenerize Psychiatry PLLC?
- The authorized official listed on Regenerize Psychiatry PLLC's NPPES record is Radley Peterson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Regenerize Psychiatry PLLC's NPI active?
- Yes — Regenerize Psychiatry PLLC's NPI (1043054075) is active in the NPPES registry as of the last update on 2024-10-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.