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JACOB L. LUFKIN C.R.N.A.
NPI 1457741167
Nurse Anesthetist, Certified Registered in Montpelier, ID

Active since February 02, 2015
164 S 5TH ST, MONTPELIER, ID 83254(208) 847-1630 Get Directions Write a Review

NPPES record last updated: March 23, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacob L. Lufkin C.r.n.a. NPPES

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

JACOB L. LUFKIN C.R.N.A. (NPI 1457741167) is an individual nurse anesthetist, certified registered in Montpelier, Idaho, licensed in Idaho (57248) and active in the NPI registry since February 2015. He maintains a secondary practice location in Fort Wayne.

NPPES Registry Identity

NPI1457741167
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJACOB L. LUFKINCredential: C.R.N.A.
Location Address164 S 5TH STMontpelier, ID 83254-1597
Mailing Address123 Valley View DrMontpelier, ID 83254-1529 · (208) 604-5009
Phone(208) 847-1630
Sole ProprietorNo
Enumeration DateFebruary 2, 2015
Last NPPES UpdateMarch 23, 2020
NPPES CertifiedMarch 23, 2020
✔ NPI 1457741167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in ID · 57248
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License 28219682A (IN)
164 S 5TH ST, Montpelier, ID 83254
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Secondary Practice Location 1

Location 15734 Coventry LnFort Wayne, IN 46804-7141 · Phone (260) 436-7875 ext. 226 · Fax (260) 432-9812

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob L. Lufkin C.r.n.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

4

Medicare enrollment records show Jacob Lufkin reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bear Lake County Memorial Hospital
Same address
Orthopaedic Surgery
164 S 5TH ST
Montpelier, ID 83254
  • Reassigned Medicare billing, Idaho enrollment
  • Also billed through NPI 1336125533 (Idaho)
  • 32 clinicians in this Medicare group
NPI 1376871749 (208) 847-4354
Franklin County Medical Center
33 mi
Critical Access
44 N 1ST E
Preston, ID 83263
  • Reassigned Medicare billing, Idaho enrollment
  • 49 clinicians in this Medicare group
NPI 1548355811 (208) 852-0137
Oneida County Hospital
49 mi
Critical Access
150 N 200 W
Malad, ID 83252
  • Reassigned Medicare billing, Idaho enrollment
  • 31 clinicians in this Medicare group
NPI 1609826270 (208) 766-2231
Community Hospital
365 mi
Critical Access
2000 CAMPBELL DR
Torrington, WY 82240
  • Reassigned Medicare billing, Wyoming enrollment
  • 78 clinicians in this Medicare group
NPI 1669410643 (307) 532-4181

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

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.

ALEX MICHAEL CARR FNP
Nurse Practitioner (Family)
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-1630
GREGORY WILLIAM HYDE DPT
Physical Therapist
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-4417
JOSEPH DAYTON
Physician Assistant
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-4359
JUSTIN RICHARD BRUNNER DPT
Physical Therapist (Orthopedic)
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-4417
BONNIE COLLEEN CAYWOOD RD
Dietitian, Registered
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-1630
BEAR LAKE COUNTY MEMORIAL HOSPITAL
General Acute Care Hospital (Critical Access)
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-1630
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Orthopaedic Surgery
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-4354
RICHARD BERGMAN LSW
Social Worker
164 S 5TH ST
MONTPELIER, ID 83254
Bear Lake County (208) 847-4464

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 Jacob Lufkin's NPI number?

The NPI number for Jacob Lufkin is 1457741167. It was assigned to this individual provider in the NPPES registry on February 2, 2015.

Where is Jacob Lufkin located?

Jacob Lufkin practices at 164 S 5th St, Montpelier, ID 83254. The listed phone number is (208) 847-1630.

What is Jacob Lufkin's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Jacob Lufkin enrolled in Medicare?

Yes. Jacob Lufkin is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jacob Lufkin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Lufkin reassigns Medicare benefits to 4 organizations: Bear Lake County Memorial Hospital (Montpelier, ID), Franklin County Medical Center (Preston, ID), Oneida County Hospital (Malad, ID) and Community Hospital (Torrington, WY). Each 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 Jacob Lufkin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacob Lufkin accept?

Health plans from Select Health list Jacob Lufkin 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 Jacob Lufkin was last updated on March 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.