GEM STATE ENT, PLLC
NPI 1215715669
General Practice in Twin Falls, ID

Q: What is Gem State Ent, PLLC's NPI number?

The NPI number for Gem State Ent, PLLC is 1215715669. It was assigned to this organization in the NPPES registry on September 18, 2023.

Q: What is Gem State Ent, PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since September 18, 2023

2102 CANYON PLAZA DR, TWIN FALLS, ID 83301(208) 352-7555(208) 352-7333 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Gem State Ent, Pllc NPPES

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

GEM STATE ENT, PLLC (NPI 1215715669) is a healthcare organization registered as a general practice in Twin Falls, Idaho and active in the NPI registry since September 2023. The organization maintains 2 additional practice locations and lists Brooke Freidenberger, Medical Coder, as its authorized official.

NPPES Registry Identity

NPI1215715669

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameGEM STATE ENT, PLLC

Location Address2102 CANYON PLAZA DRTwin Falls, ID 83301-4513

Mailing Address2114 Village Park Ave # 200Twin Falls, ID 83301-4172 · (208) 804-1717 · Fax (208) 804-1707

Phone(208) 352-7555

Fax(208) 352-7333

Organization SubpartNo

Authorized OfficialBrooke FreidenbergerMedical Coder · (208) 858-6008

Enumeration DateSeptember 18, 2023

Last NPPES UpdateApril 8, 2025

NPPES CertifiedApril 8, 2025

✔ NPI 1215715669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

2102 CANYON PLAZA DR, Twin Falls, ID 83301

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Secondary Practice Locations 2

Location 1314 S River StHailey, ID 83333-8851 · Phone (208) 352-7555 · Fax (208) 352-7333

Location 21501 Hiland Ave Ste MBurley, ID 83318-2688 · Phone (208) 352-7555 · Fax (208) 352-7333

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gem State Ent, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 7 clinicians reassign Medicare billing to Gem State Ent, PLLC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Kylan Peterson, D.O.

Otolaryngology

NPI 1750542452

730 N COLLEGE RD SUITE B
Twin Falls, ID 83301

(208) 814-7350

✔ PECOS✔ Accepts Medicare1.2 mi

Russell Mayes, D.O.

Otolaryngology

NPI 1316162704

730 N COLLEGE RD SUITE B
Twin Falls, ID 83301

(208) 814-7350

✔ PECOS✔ Accepts Medicare1.2 mi

Robert Jensen, AU.D.

Qualified Audiologist

NPI 1629424171

730 N COLLEGE RD STE B
Twin Falls, ID 83301

(208) 732-8508

✔ Accepts Medicare1.2 mi

Charles Larson, FNP-BC

Nurse Practitioner

NPI 1497120349

730 N COLLEGE RD STE B
Twin Falls, ID 83301

(208) 814-7350

✔ PECOS✔ Accepts Medicare1.2 mi

Robert Butler

Nurse Practitioner

NPI 1255970976

201 LINCOLN ST
Twin Falls, ID 83301

(435) 419-0210

✔ PECOS✔ Accepts Medicare2.0 mi

Skylar Muniz, AU.D.

Qualified Audiologist

NPI 1710502281

625 POLE LINE RD W STE 2B
Twin Falls, ID 83301

(208) 814-7350

✔ Accepts Medicare2.5 mi

Andrew Goates, MD

Otolaryngology

NPI 1033614458

1350 N 500 E
Logan, UT 84341

(435) 752-1693

✔ PECOS✔ Accepts Medicare145 mi

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 Gem State Ent, PLLC's NPI number?

The NPI number for Gem State Ent, PLLC is 1215715669. It was assigned to this organization in the NPPES registry on September 18, 2023.

Where is Gem State Ent, PLLC located?

Gem State Ent, PLLC is located at 2102 Canyon Plaza Dr, Twin Falls, ID 83301. The listed phone number is (208) 352-7555.

What is Gem State Ent, PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Gem State Ent, PLLC enrolled in Medicare?

Yes. Gem State Ent, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gem State Ent, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Gem State Ent, PLLC. 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. The largest specialties are Otolaryngology (3), Nurse Practitioner (2) and Qualified Audiologist (2). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Gem State Ent, PLLC accept?

Health plans from Molina Healthcare list Gem State Ent, PLLC 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 Gem State Ent, PLLC was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.