MATTHEW J FACKRELL DO
NPI 1215968045
Family Medicine in Blackfoot, ID

Q: What is Matthew Fackrell's NPI number?

The NPI number for Matthew Fackrell is 1215968045. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Q: What is Matthew Fackrell's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Matthew Fackrell was last updated on October 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment

1441 PARKWAY DR, BLACKFOOT, ID 83221(208) 785-2600(208) 785-8185 Get Directions Write a Review

NPPES record last updated: October 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Matthew J Fackrell Do NPPES

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

MATTHEW J FACKRELL DO (NPI 1215968045) is an individual family medicine provider in Blackfoot, Idaho, licensed in Colorado (DR.0073268) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Portneuf Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1215968045

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMATTHEW J FACKRELLCredential: DO

Location Address1441 PARKWAY DRBlackfoot, ID 83221-1667

Mailing Address1441 Parkway DrBlackfoot, ID 83221-1667 · (208) 785-2600 · Fax (208) 785-8185

Phone(208) 785-2600

Fax(208) 785-8185

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateJuly 6, 2006

Last NPPES UpdateOctober 22, 2024

NPPES CertifiedOctober 22, 2024

✔ NPI 1215968045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in CO · DR.0073268✔ Licensed in WA · OP61556804✔ Licensed in OR · DO221842✔ Licensed in PA · OS024313

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.

1441 PARKWAY DR, Blackfoot, ID 83221

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Other Identifiers 2

Other1374716ID · Ptan

Medicaid807815500ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska, Providence Health Plan 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

Matthew J Fackrell Do 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 ID2668400458

PECOS Enrollment IDI20070924000249, I20260203002993

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 4

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

Portneuf Medical Center

Acute Care Hospitals · Pocatello, ID

4/5 CMS rating

OwnershipProprietary

CMS Certification Number130028

Location777 Hospital WayPocatello, ID 83201 · Bannock County

Emergency services Birthing friendly

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

Idaho Falls Community Hospital, LLC

Acute Care Hospitals · Idaho Falls, ID

3/5 CMS rating

OwnershipProprietary

CMS Certification Number130074

Location2327 Coronado StIdaho Falls, ID 83404 · Bonneville County

Emergency services

Bingham Memorial Hospital

Critical Access Hospitals · Blackfoot, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131325

Location98 Poplar StreetBlackfoot, ID 83221 · Bingham County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83221 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

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

2 suppliers13 claims36 services$6.69 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier13 claims13 services$56.41 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers51 claims51 services$20.40 avg. paid by Medicare

Stationary oxygen contents, liquid, 1 month's supply = 1 unit E0442

DME-Oxygen and Supplies · category DC000N

1 supplier24 claims24 services$49.63 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers11 claims11 services$43.21 avg. paid by Medicare

Portable oxygen contents, liquid, 1 month's supply = 1 unit E0444

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$48.51 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

SHAWNA MARIE REYNOLDS PA

Physician Assistant