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PAIN MANAGEMENT OF NORTH IDAHO, PLLC
NPI 1467583153
Pain Medicine - Interventional Pain Medicine in Coeur D Alene, ID

Active since March 07, 2007CLIA 13D2017382 · Waiver
1686 W RIVERSTONE DR, STE 1, COEUR D ALENE, ID 83814(208) 765-4807(208) 765-2903 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 26, 2025, Mar 14, 2023, Sep 29, 2016 (3 updates tracked since 2016).

About Pain Management Of North Idaho, Pllc NPPES

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

PAIN MANAGEMENT OF NORTH IDAHO, PLLC (NPI 1467583153) is a healthcare organization registered as an interventional pain medicine in Coeur D Alene, Idaho and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through December 9, 2026 and lists Tina Marie Botai, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1467583153
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NamePAIN MANAGEMENT OF NORTH IDAHO, PLLC
Location Address1686 W RIVERSTONE DR, STE 1Coeur D Alene, ID 83814-5779
Mailing Address1686 W Riverstone Dr, Ste 1Coeur D Alene, ID 83814-5779 · (208) 765-4807 · Fax (866) 573-0853
Phone(208) 765-4807
Fax(208) 765-2903
Organization SubpartNo
Authorized OfficialTina Marie BotaiPractice Administrator · (208) 765-4807
Enumeration DateMarch 7, 2007
Last NPPES UpdateJune 26, 20253 updates tracked since enumeration
NPPES CertifiedJune 26, 2025
✔ NPI 1467583153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in ID · M7860
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
1686 W RIVERSTONE DR, Coeur D Alene, ID 83814
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Pain Management Of North Idaho, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Pain Management Of North Idaho, PLLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Regina Marie Kendra
Nurse Practitioner
NPI 1790192284
1686 W RIVERSTONE DR
Coeur D Alene, ID 83814
(208) 762-0480
✔ PECOS✔ Accepts MedicareSame address
Denise Love, ARNP
Nurse Practitioner
NPI 1972944866
1686 W RIVERSTONE DR STE 1
Coeur D Alene, ID 83814
(208) 765-4807
✔ PECOS✔ Accepts MedicareSame address
Scott Magnuson, MD
Interventional Pain Management
NPI 1174593404
1686 W RIVERSTONE DR STE 1
Coeur D Alene, ID 83814
(208) 765-4807
✔ PECOS✔ Accepts MedicareSame address
Denise Struhs, ARNP
Nurse Practitioner
NPI 1114763489
1686 W RIVERSTONE DR
Coeur D Alene, ID 83814
(208) 765-4807
✔ PECOS✔ Accepts MedicareSame address
Clinton Thome, M.D.
Anesthesiology
NPI 1558654756
1686 W RIVERSTONE DR STE 1
Coeur D Alene, ID 83814
(208) 765-4807
✔ PECOS✔ Accepts MedicareSame address
Reva Reese, FNP
Nurse Practitioner
NPI 1578996740
701 HOSPITAL LOOP
Fairchild Afb, WA 99011
(509) 247-5661
✔ PECOS40 mi

Source: 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 13D2017382

Pain Management Of North Idaho · Coeur D'alene, ID
Active · expires Dec 9, 2026
CLIA Number13D2017382
Laboratory TypePhysician Office
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorScott Magnuson
Laboratory Phone(208) 765-4807
Laboratory LocationPain Management Of North Idaho1686 W Riverstone Dr, Coeur D'alene, ID 83814
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Pain Management Of North Idaho, PLLC's NPI number?

The NPI number for Pain Management Of North Idaho, PLLC is 1467583153. It was assigned to this organization in the NPPES registry on March 7, 2007.

Where is Pain Management Of North Idaho, PLLC located?

Pain Management Of North Idaho, PLLC is located at 1686 W Riverstone Dr Ste 1, Coeur D Alene, ID 83814. The listed phone number is (208) 765-4807.

What is Pain Management Of North Idaho, PLLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Pain Management Of North Idaho, PLLC enrolled in Medicare?

Yes. Pain Management Of North Idaho, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pain Management Of North Idaho, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Pain Management Of North Idaho, PLLC. 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 (4), Anesthesiology (1) and Interventional Pain Management (1). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pain Management Of North Idaho, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2017382) is associated with this NPI, valid through December 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pain Management Of North Idaho, PLLC accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare and Premera Blue Cross Blue Shield of Alaska list Pain Management Of North Idaho, PLLC 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 Pain Management Of North Idaho, PLLC was last updated on June 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.