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TATE COLTAN STAKER PA-C
NPI 1184253585
Physician Assistant in Rexburg, ID

Active since April 07, 2020PECOS EnrolledAccepts Medicare Assignment
130 W MAIN ST, REXBURG, ID 83440(208) 356-8818 Get Directions Write a Review

NPPES record last updated: October 28, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tate Coltan Staker Pa-c NPPES

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

TATE COLTAN STAKER PA-C (NPI 1184253585) is an individual physician assistant in Rexburg, Idaho, licensed in Idaho (PA-1932) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Mountain View Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1184253585
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameTATE COLTAN STAKERCredential: PA-C
Location Address130 W MAIN STRexburg, ID 83440-1827
Mailing Address130 W Main StRexburg, ID 83440-1827 · (208) 356-8818
Phone(208) 356-8818
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateApril 7, 2020
Last NPPES UpdateOctober 28, 2021
NPPES CertifiedOctober 28, 2021
✔ NPI 1184253585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · PA-1932
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
130 W MAIN ST, Rexburg, ID 83440
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan, Select Health and more.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

Tate Coltan Staker Pa-c 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 ID1456767508
PECOS Enrollment IDI20210315002575
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mountain View Hospital

Acute Care Hospitals · Idaho Falls, ID
1/5 CMS rating
OwnershipPhysician
CMS Certification Number130065
Location2325 Coronado StreetIdaho Falls, ID 83404 · Bonneville County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83440 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
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
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 Tate Staker's NPI number?

The NPI number for Tate Staker is 1184253585. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Tate Staker located?

Tate Staker practices at 130 W Main St, Rexburg, ID 83440. The listed phone number is (208) 356-8818.

What is Tate Staker's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tate Staker enrolled in Medicare?

Yes. Tate Staker 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 Tate Staker accept?

Health plans from Moda Health Plan, Inc., Providence Health Plan, Select Health and University of Utah Health Plans list Tate Staker 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.

Is Tate Staker affiliated with any hospitals?

According to CMS data, Tate Staker is affiliated with Mountain View Hospital.

When was this NPI record last updated?

The NPPES record for Tate Staker was last updated on October 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.