DR. MITCHELL JACKSON MOFFITT M.D.
NPI 1093895229
Pediatrics in Twin Falls, ID
About Dr. Mitchell Jackson Moffitt M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MITCHELL JACKSON MOFFITT M.D. (NPI 1093895229) is an individual pediatrics provider in Twin Falls, Idaho, licensed in Idaho (M-10017) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Mitchell Jackson Moffitt M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mitchell Moffitt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Twin Falls, ID 83301
- Reassigned Medicare billing, Idaho enrollment
- Medicare enrollment name: St Lukes Clinic LLC
- 322 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TWIN FALLS, ID 83301
TWIN FALLS, ID 83301
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 Mitchell Moffitt's NPI number?
The NPI number for Mitchell Moffitt is 1093895229. It was assigned to this individual provider in the NPPES registry on October 16, 2006.
Where is Mitchell Moffitt located?
Mitchell Moffitt practices at 775 Pole Line Rd W Suite 111, Twin Falls, ID 83301. The listed phone number is (208) 814-8000.
What is Mitchell Moffitt's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Mitchell Moffitt enrolled in Medicare?
Yes. Mitchell Moffitt is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mitchell Moffitt's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mitchell Moffitt reassigns Medicare benefits to St Luke's Clinic LLC (Twin Falls, ID). The 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 Mitchell Moffitt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mitchell Moffitt accept?
Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Mitchell Moffitt 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 Mitchell Moffitt was last updated on January 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Dr. Mitchell Jackson Moffitt, M.D. · NPI 1093895229
Pediatrics physician in Twin Falls, Idaho. Individual provider, active in the CMS NPPES registry since October 16, 2006.
## Identity
- **NPI:** 1093895229 (Entity type: Individual)
- **Enumerated:** October 16, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** M-10017 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 775 POLE LINE RD W, SUITE 111, Twin Falls, ID 83301-5814
- **Phone:** (208) 814-8000 · **Fax:** (208) 733-9402
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Luke's Clinic LLC (NPI 1790718229, Twin Falls, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2015
- **Other identifiers:** Medicaid 807839500 (ID); Medicare PIN 11000701 (ID)
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Source: [NPI Profile](https://npiprofile.com/npi/1093895229) · Data from the CMS NPPES public registry.