REGENERIZE PSYCHIATRY PLLC
NPI 1043054075
Clinic/Center - Mental Health (Including Community Mental Health Center) in Sandpoint, ID
About Regenerize Psychiatry Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REGENERIZE PSYCHIATRY PLLC (NPI 1043054075) is a healthcare organization registered as a mental health (including community mental health center) in Sandpoint, Idaho and active in the NPI registry since June 2024. The organization lists Radley Peterson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Regenerize Psychiatry 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 Regenerize Psychiatry PLLC, which bills Medicare for the services they deliver. 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.
Frequently 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 Regenerize Psychiatry PLLC's NPI number?
The NPI number for Regenerize Psychiatry PLLC is 1043054075. It was assigned to this organization in the NPPES registry on June 24, 2024.
Where is Regenerize Psychiatry PLLC located?
Regenerize Psychiatry PLLC is located at 605 S Olive Ave, Sandpoint, ID 83864. The listed phone number is (209) 677-7747.
What is Regenerize Psychiatry PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Regenerize Psychiatry PLLC enrolled in Medicare?
Yes. Regenerize Psychiatry PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Regenerize Psychiatry PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Regenerize Psychiatry PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Regenerize Psychiatry PLLC accept?
Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Regenerize Psychiatry 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 Regenerize Psychiatry PLLC was last updated on October 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Regenerize Psychiatry Pllc · NPI 1043054075
Mental Health (Including Community Mental Health Center) organization in Sandpoint, Idaho. Organization record, active in the CMS NPPES registry since June 24, 2024.
## Identity
- **NPI:** 1043054075 (Entity type: Organization)
- **Enumerated:** June 24, 2024
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Radley Peterson, OWNER
## Practice location
- **Address:** 605 S OLIVE AVE, Sandpoint, ID 83864-1154
- **Phone:** (209) 677-7747
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 27, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1043054075) · Data from the CMS NPPES public registry.