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DR. TANNER MITCHELL NIELSEN PSYD
NPI 1346574464
Psychologist - Clinical in Idaho Falls, ID

Active since September 22, 2009PECOS Enrolled
2105 CORONADO ST, IDAHO FALLS, ID 83404(208) 534-7881(208) 203-7067 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 29, 2022, Aug 4, 2021, Dec 7, 2017 and 1 more (4 updates tracked since 2017).

About Dr. Tanner Mitchell Nielsen Psyd NPPES

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

DR. TANNER MITCHELL NIELSEN PSYD (NPI 1346574464) is an individual clinical provider in Idaho Falls, Idaho, licensed in Idaho (PSY-203073) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346574464
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. TANNER MITCHELL NIELSENCredential: PSYD
Location Address2105 CORONADO STIdaho Falls, ID 83404-7495
Mailing Address2105 Coronado StIdaho Falls, ID 83404-7495 · (208) 534-7881 · Fax (208) 203-7067
Phone(208) 534-7881
Fax(208) 203-7067
Sole ProprietorNo
Enumeration DateSeptember 22, 2009
Last NPPES UpdateJune 18, 20264 updates tracked since enumeration
NPPES CertifiedJune 18, 2026
✔ NPI 1346574464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in ID · PSY-203073
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2105 CORONADO ST, Idaho Falls, ID 83404
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tanner Mitchell Nielsen Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Tanner Nielsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

4 Pillars Of Success LLC
0.9 mi
Clinic/Center
1675 CURLEW DR
Ammon, ID 83406
  • Reassigned Medicare billing, Idaho enrollment
  • Medicare enrollment name: Badger Inc
  • 11 clinicians in this Medicare group
NPI 1457698565 (208) 523-5319

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83404 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
$160.17 typical visit price
range $52.44 – $160.17
Typical copayment $40.04 (range $13.11 – $40.04)
Most-billed visit code 99205
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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WADE DARREN LEAVITT LMSW
Social Worker
2105 CORONADO ST
IDAHO FALLS, ID 83404
Bonneville County (208) 534-7881
EMILY PORTER
Psychologist (Counseling)
2105 CORONADO ST
IDAHO FALLS, ID 83404
Bonneville County (208) 534-7881
CANDICE SCHEMPP LPC
Counselor (Professional)
2105 CORONADO ST
IDAHO FALLS, ID 83404
Bonneville County (208) 534-7881

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 Tanner Nielsen's NPI number?

The NPI number for Tanner Nielsen is 1346574464. It was assigned to this individual provider in the NPPES registry on September 22, 2009.

Where is Tanner Nielsen located?

Tanner Nielsen practices at 2105 Coronado St, Idaho Falls, ID 83404. The listed phone number is (208) 534-7881.

What is Tanner Nielsen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Tanner Nielsen enrolled in Medicare?

Yes. Tanner Nielsen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tanner Nielsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tanner Nielsen reassigns Medicare benefits to 4 Pillars Of Success LLC (Ammon, ID). The 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 Tanner Nielsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tanner Nielsen accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans, Select Health and University of Utah Health Plans list Tanner Nielsen 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 Tanner Nielsen was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.