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STEELE LAKE SPECIALTY PLLC
NPI 1215716998
Surgery in Idaho Falls, ID

Active since September 22, 2023
3200 CHANNING WAY STE A206, IDAHO FALLS, ID 83404(208) 529-2230 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Steele Lake Specialty Pllc NPPES

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

STEELE LAKE SPECIALTY PLLC (NPI 1215716998) is a healthcare organization registered as a surgery in Idaho Falls, Idaho and active in the NPI registry since September 2023. The organization lists Abra Wasia, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1215716998
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameSTEELE LAKE SPECIALTY PLLC
Location Address3200 CHANNING WAY STE A206Idaho Falls, ID 83404-7586
Mailing Address3200 Channing Way Ste A206Idaho Falls, ID 83404-7586 · (208) 529-2230
Phone(208) 529-2230
Organization SubpartNo
Authorized OfficialAbra WasiaOffice Manager · (208) 529-2330
Enumeration DateSeptember 22, 2023
Last NPPES UpdateJuly 17, 2026
NPPES CertifiedJuly 17, 2026
✔ NPI 1215716998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
3200 CHANNING WAY STE A206, Idaho Falls, ID 83404
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., 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)

Steele Lake Specialty Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Steele Lake Specialty PLLC, which bills Medicare for the services they deliver. Of these, 10 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 4

General Surgery5
Nurse Practitioner3
Plastic and Reconstructive Surgery1
Podiatry1

Clinicians, nearest first (10)

Kara Boll
Nurse Practitioner
NPI 1417498890
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Steven Cook, NP-C
Nurse Practitioner
NPI 1114494366
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Nicholas Johnson, MD
Plastic and Reconstructive Surgery
NPI 1578850210
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Michael Lemon, DO
General Surgery
NPI 1558529222
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Adam Meziani, M.D.
General Surgery
NPI 1326427360
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Tait Olaveson, D.O.
General Surgery
NPI 1356518831
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Tony Quinton, DPM
Podiatry
NPI 1639157621
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Chance Smith
General Surgery
NPI 1598388019
3200 CHANNING WAY STE A206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Joshua Summers, DO
General Surgery
NPI 1477848851
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address
Tyson Smithersen, FNP
Nurse Practitioner
NPI 1679233134
3200 CHANNING WAY STE 206
Idaho Falls, ID 83404
(208) 529-2230
✔ PECOS✔ Accepts MedicareSame address

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 Steele Lake Specialty PLLC's NPI number?

The NPI number for Steele Lake Specialty PLLC is 1215716998. It was assigned to this organization in the NPPES registry on September 22, 2023.

Where is Steele Lake Specialty PLLC located?

Steele Lake Specialty PLLC is located at 3200 Channing Way Ste A206, Idaho Falls, ID 83404. The listed phone number is (208) 529-2230.

What is Steele Lake Specialty PLLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Steele Lake Specialty PLLC enrolled in Medicare?

Yes. Steele Lake Specialty PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Steele Lake Specialty PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 4 Medicare specialties reassign their Medicare billing to Steele Lake Specialty 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 General Surgery (5), Nurse Practitioner (3) and Plastic and Reconstructive Surgery (1). Of these, 10 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Steele Lake Specialty PLLC accept?

Health plans from Moda Health Plan, Inc. and Molina Healthcare list Steele Lake Specialty 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 Steele Lake Specialty PLLC was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.