BLUE LAKES MEDICINE PA
NPI 1063872489
Nurse Practitioner - Family in Twin Falls, ID
About Blue Lakes Medicine Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE LAKES MEDICINE PA (NPI 1063872489) is a healthcare organization registered as a family in Twin Falls, Idaho and active in the NPI registry since February 2016. The organization lists Howard Rusty Arrington, Provider / Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blue Lakes Medicine Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Blue Lakes Medicine PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Blue Lakes Medicine PA's NPI number?
The NPI number for Blue Lakes Medicine PA is 1063872489. It was assigned to this organization in the NPPES registry on February 26, 2016.
Where is Blue Lakes Medicine PA located?
Blue Lakes Medicine PA is located at 1122 Eastland Dr N Ste 2, Twin Falls, ID 83301. The listed phone number is (208) 734-9531.
What is Blue Lakes Medicine PA's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Blue Lakes Medicine PA enrolled in Medicare?
Yes. Blue Lakes Medicine PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blue Lakes Medicine PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Blue Lakes Medicine PA. 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.
When was this NPI record last updated?
The NPPES record for Blue Lakes Medicine PA was last updated on February 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Blue Lakes Medicine Pa · NPI 1063872489
Family organization in Twin Falls, Idaho. Organization record, active in the CMS NPPES registry since February 26, 2016.
## Identity
- **NPI:** 1063872489 (Entity type: Organization)
- **Enumerated:** February 26, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Howard Arrington, PROVIDER / OWNER
## Practice location
- **Address:** 1122 EASTLAND DR N, STE 2, Twin Falls, ID 83301-8444
- **Phone:** (208) 734-9531 · **Fax:** (208) 733-6969
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 26, 2016
- **Other identifiers:** Other 1374328 (ID)
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Source: [NPI Profile](https://npiprofile.com/npi/1063872489) · Data from the CMS NPPES public registry.