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CONNOR REZZONICO PMHNP
NPI 1063184968
Nurse Practitioner - Psychiatric/Mental Health in Coeur D Alene, ID

Active since September 29, 2021PECOS EnrolledAccepts Medicare Assignment
1110 W PARK PL STE 222, COEUR D ALENE, ID 83814(208) 625-7695(949) 864-3567 Get Directions Write a Review

NPPES record last updated: May 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 20, 2026, Mar 4, 2025, Oct 31, 2022 and 1 more (4 updates tracked since 2021).

About Connor Rezzonico Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNOR REZZONICO PMHNP (NPI 1063184968) is an individual psychiatric/mental health provider in Coeur D Alene, Idaho, licensed in Idaho (74368) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Coeur D Alene, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1063184968
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameCONNOR REZZONICOCredential: PMHNP
Location Address1110 W PARK PL STE 222Coeur D Alene, ID 83814-2784
Mailing Address1110 W Park Pl Ste 222Coeur D Alene, ID 83814-2784 · (208) 625-7695 · Fax (949) 864-3597
Phone(208) 625-7695
Fax(949) 864-3567
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 29, 2021
Last NPPES UpdateMay 20, 20264 updates tracked since enumeration
NPPES CertifiedMay 20, 2026
✔ NPI 1063184968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in ID · 74368✔ Licensed in WA · AP70005328
1110 W PARK PL STE 222, Coeur D Alene, ID 83814
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Secondary Practice Location 1

Location 12003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · Phone (208) 625-4870 · Fax (208) 625-4878

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Connor Rezzonico Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729458690
PECOS Enrollment IDI20230111000009
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
166 services35 patients
Testing for presence of drug, read by direct observation 80305
Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Connor Rezzonico's NPI number?

The NPI number for Connor Rezzonico is 1063184968. It was assigned to this individual provider in the NPPES registry on September 29, 2021.

Where is Connor Rezzonico located?

Connor Rezzonico practices at 1110 W Park Pl Ste 222, Coeur D Alene, ID 83814. The listed phone number is (208) 625-7695.

What is Connor Rezzonico's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Connor Rezzonico enrolled in Medicare?

Yes. Connor Rezzonico is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Connor Rezzonico accept?

Health plans from Moda Health Plan, Inc. list Connor Rezzonico 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 Connor Rezzonico was last updated on May 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.