Idaho Modern Medicine - PLLC
NPI 1184255754 · Family Medicine Physician · Pocatello, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Idaho Modern Medicine - PLLC is a Family Medicine Physician organization in Pocatello, ID (NPI 1184255754).
Provider details
- NPI number
- 1184255754
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michael Anderson, Physician / Owner(208) 648-4789
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs 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
- 2020-01-31
- Last updated
- 2024-02-05
- Certified
- 2024-02-05
Frequently asked questions
- What is Idaho Modern Medicine - PLLC's NPI number?
- Idaho Modern Medicine - PLLC's National Provider Identifier (NPI) is 1184255754, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Idaho Modern Medicine - PLLC?
- Idaho Modern Medicine - PLLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Idaho Modern Medicine - PLLC located?
- Idaho Modern Medicine - PLLC's practice location on file with NPPES is 1000 Pocatello Creek Rd Ste E10, Pocatello, ID 83201-2953.
- What is Idaho Modern Medicine - PLLC's phone number?
- The practice phone number listed in the NPPES registry for Idaho Modern Medicine - PLLC is (208) 317-5371.
- Does Idaho Modern Medicine - PLLC accept Medicare?
- Idaho Modern Medicine - 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 Idaho Modern Medicine - PLLC?
- The authorized official listed on Idaho Modern Medicine - PLLC's NPPES record is Michael Anderson, Physician / Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Idaho Modern Medicine - PLLC's NPI active?
- Yes — Idaho Modern Medicine - PLLC's NPI (1184255754) is active in the NPPES registry as of the last update on 2024-02-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.