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OPEN SPACE MENTAL HEALTH LLC
NPI 1235947524
Psychiatry & Neurology - Psychiatry in Idaho Falls, ID

Active since December 19, 2024
530 S HOLMES AVE, IDAHO FALLS, ID 83401(307) 690-2938 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Open Space Mental Health Llc NPPES

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

OPEN SPACE MENTAL HEALTH LLC (NPI 1235947524) is a healthcare organization registered as a psychiatry in Idaho Falls, Idaho and active in the NPI registry since December 2024. The organization lists Benjamin G Rae, Owner, as its authorized official.

NPPES Registry Identity

NPI1235947524
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameOPEN SPACE MENTAL HEALTH LLC
Location Address530 S HOLMES AVEIdaho Falls, ID 83401-5056
Mailing AddressPo Box 955Wilson, WY 83014-0955 · (307) 690-2938
Phone(307) 690-2938
Organization SubpartNo
Authorized OfficialBenjamin G RaeOwner · (307) 690-2938
Enumeration DateDecember 19, 2024
NPPES CertifiedDecember 19, 2024
✔ NPI 1235947524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
530 S HOLMES AVE, Idaho Falls, ID 83401
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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 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)

Open Space Mental Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Open Space Mental Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Benjamin Rae
Nurse Practitioner
NPI 1770051229
530 S HOLMES AVE
Idaho Falls, ID 83401
(208) 924-4360
✔ PECOS✔ Accepts Medicare0.6 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 Open Space Mental Health LLC's NPI number?

The NPI number for Open Space Mental Health LLC is 1235947524. It was assigned to this organization in the NPPES registry on December 19, 2024.

Where is Open Space Mental Health LLC located?

Open Space Mental Health LLC is located at 530 S Holmes Ave, Idaho Falls, ID 83401. The listed phone number is (307) 690-2938.

What is Open Space Mental Health LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Open Space Mental Health LLC enrolled in Medicare?

Yes. Open Space Mental Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Open Space Mental Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Open Space Mental Health LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Open Space Mental Health LLC accept?

Health plans from Molina Healthcare list Open Space Mental Health LLC 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 Open Space Mental Health LLC was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.