MAGIC VALLEY PAIN SPECIALISTS, PLLC
NPI 1003564998
Anesthesiology - Pain Medicine in Burley, ID
About Magic Valley Pain Specialists, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAGIC VALLEY PAIN SPECIALISTS, PLLC (NPI 1003564998) is a healthcare organization registered as a pain medicine in Burley, Idaho and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through December 1, 2027 and lists Tyler C Roe, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Magic Valley Pain Specialists, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Magic Valley Pain Specialists, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 13D2244482
Magic Valley Pain Specialists · Burley, IDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Magic Valley Pain Specialists, PLLC's NPI number?
The NPI number for Magic Valley Pain Specialists, PLLC is 1003564998. It was assigned to this organization in the NPPES registry on March 10, 2022.
Where is Magic Valley Pain Specialists, PLLC located?
Magic Valley Pain Specialists, PLLC is located at 1344 Hiland Ave Ste A, Burley, ID 83318. The listed phone number is (208) 678-7246.
What is Magic Valley Pain Specialists, PLLC's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.
Is Magic Valley Pain Specialists, PLLC enrolled in Medicare?
Yes. Magic Valley Pain Specialists, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Magic Valley Pain Specialists, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Magic Valley Pain Specialists, PLLC, in Nurse Practitioner and Pain Management. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Magic Valley Pain Specialists, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2244482) is associated with this NPI, valid through December 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Magic Valley Pain Specialists, PLLC accept?
Health plans from Molina Healthcare list Magic Valley Pain Specialists, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Magic Valley Pain Specialists, PLLC was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Magic Valley Pain Specialists, Pllc · NPI 1003564998
Pain Medicine organization in Burley, Idaho. Organization record, active in the CMS NPPES registry since March 10, 2022.
## Identity
- **NPI:** 1003564998 (Entity type: Organization)
- **Enumerated:** March 10, 2022
- **Primary specialty:** Anesthesiology - Pain Medicine · taxonomy 207LP2900X
- **Organization subpart:** No
- **Authorized official:** Tyler Roe, OWNER
## Practice location
- **Address:** 1344 HILAND AVE STE A, Burley, ID 83318-1564
- **Phone:** (208) 678-7246
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (1), Pain Management (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 27, 2022
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1003564998) · Data from the CMS NPPES public registry.