SPENCER GARRETT SEIBOLD D.O.
NPI 1114214731
Family Medicine in American Falls, ID

Q: What is Spencer Seibold's NPI number?

The NPI number for Spencer Seibold is 1114214731. It was assigned to this individual provider in the NPPES registry on July 3, 2011.

Q: What is Spencer Seibold's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: Is Spencer Seibold enrolled in Medicare?

No. Spencer Seibold has opted out of Medicare through December 20, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Spencer Seibold was last updated on April 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since July 03, 2011Opted out of Medicare · through Dec 20, 2026

502 TYHEE AVE, AMERICAN FALLS, ID 83211(208) 226-3200 Get Directions Write a Review

NPPES record last updated: April 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 26, 2019, Apr 15, 2019 (2 updates tracked since 2019).

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About Spencer Garrett Seibold D.o. NPPES

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

SPENCER GARRETT SEIBOLD D.O. (NPI 1114214731) is an individual family medicine provider in American Falls, Idaho, licensed in Idaho (O-0803) and active in the NPI registry since July 2011. He has opted out of Medicare through December 20, 2026 and maintains a secondary practice location in Aberdeen.

NPPES Registry Identity

NPI1114214731

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSPENCER GARRETT SEIBOLDCredential: D.O.

Location Address502 TYHEE AVEAmerican Falls, ID 83211-1224

Mailing Address510 Roosevelt StAmerican Falls, ID 83211-1362

Phone(208) 226-3200

Sole ProprietorNo

Enumeration DateJuly 3, 2011

Last NPPES UpdateApril 26, 20192 updates tracked since enumeration

✔ NPI 1114214731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · O-0803

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

502 TYHEE AVE, American Falls, ID 83211

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Secondary Practice Location 1

Location 150 S MainAberdeen, ID 83210 · Phone (208) 226-3200

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Spencer Garrett Seibold D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 20, 2022 through December 20, 2026.

Opt-Out Effective DateDecember 20, 2022

Opt-Out In Effect ThroughDecember 20, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LEEANN BOLGEN FNP-C

Nurse Practitioner (Family)