TRI-STATE MEMORIAL HOSPITAL
NPI 1386690907
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Lewiston, ID
About Tri-state Memorial Hospital NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRI-STATE MEMORIAL HOSPITAL (NPI 1386690907), doing business as Tri State Dialysis Center, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Lewiston, Idaho and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Alex C. Town, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tri-state Memorial Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
25Medicare enrollment records show 25 clinicians reassign Medicare billing to Tri-State Memorial Hospital, which bills Medicare for the services they deliver. Of these, 22 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 12
Nearest to this location (20)
See all 25Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 50D2209781
Tri-State Dialysis Center · Clarkston, WAFrequently 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 Tri-State Memorial Hospital's NPI number?
The NPI number for Tri-State Memorial Hospital is 1386690907. It was assigned to this organization in the NPPES registry on May 25, 2006. The provider was formerly known as Tri State Dialysis Center.
Where is Tri-State Memorial Hospital located?
Tri-State Memorial Hospital is located at 730 21st St, Lewiston, ID 83501. The listed phone number is (208) 746-8280.
What is Tri-State Memorial Hospital's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.
Is Tri-State Memorial Hospital enrolled in Medicare?
Yes. Tri-State Memorial Hospital is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tri-State Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 25 clinicians in 12 Medicare specialties reassign their Medicare billing to Tri-State Memorial Hospital. 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 Nurse Practitioner (8), Family Practice (5) and Diagnostic Radiology (2). Of these, 22 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Tri-State Memorial Hospital hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D2209781) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Tri-State Memorial Hospital was last updated on August 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.
# Tri-State Memorial Hospital · NPI 1386690907
End-Stage Renal Disease (ESRD) Treatment organization in Lewiston, Idaho. Organization record, active in the CMS NPPES registry since May 25, 2006.
## Identity
- **NPI:** 1386690907 (Entity type: Organization)
- **Enumerated:** May 25, 2006
- **Primary specialty:** Clinic/Center - End-Stage Renal Disease (ESRD) Treatment · taxonomy 261QE0700X
- **Organization subpart:** No
- **Authorized official:** Alex Town, CFO
## Practice location
- **Address:** 730 21ST ST, Lewiston, ID 83501-3323
- **Phone:** (208) 746-8280 · **Fax:** (208) 746-8285
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 25 clinicians in 12 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Family Practice (5), Diagnostic Radiology (2); 22 practice within 10 miles; [full list](https://npiprofile.com/npi/1386690907/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 4, 2009
- **Other identifiers:** Medicare OSCAR/certification 502310 (WA); Medicare OSCAR/certification 132509; Medicaid 003110900 (ID); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1386690907) · Data from the CMS NPPES public registry.