STANFORD BENJAMIN GAMMON P.A.
NPI 1477992592
Physician Assistant - Surgical in Idaho Falls, ID

Q: What is Stanford Gammon's NPI number?

The NPI number for Stanford Gammon is 1477992592. It was assigned to this individual provider in the NPPES registry on June 21, 2013.

Q: What is Stanford Gammon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Stanford Gammon was last updated on July 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 21, 2013PECOS EnrolledAccepts Medicare Assignment

3345 POTOMAC WAY, IDAHO FALLS, ID 83404(208) 552-7572(208) 552-7312 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 7, 2022, Nov 25, 2020 (2 updates tracked since 2020).

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About Stanford Benjamin Gammon P.a. NPPES

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

STANFORD BENJAMIN GAMMON P.A. (NPI 1477992592) is an individual surgical provider in Idaho Falls, Idaho, licensed in Idaho (PA-1328) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Eastern Idaho Regional Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1477992592

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameSTANFORD BENJAMIN GAMMONCredential: P.A.

Location Address3345 POTOMAC WAYIdaho Falls, ID 83404-4978

Mailing AddressPo Box 277381Atlanta, GA 30384-7381

Phone(208) 552-7572

Fax(208) 552-7312

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJune 21, 2013

Last NPPES UpdateJuly 7, 20222 updates tracked since enumeration

NPPES CertifiedJuly 7, 2022

✔ NPI 1477992592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in ID · PA-1328

3345 POTOMAC WAY, 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., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stanford Benjamin Gammon P.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981846011

PECOS Enrollment IDI20160301001009

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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Fusion of additional segment of spine 22614

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

75 services22 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

41 services25 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment 63048

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

24 services12 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

19 services19 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

14 services14 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Eastern Idaho Regional Medical Center

Acute Care Hospitals · Idaho Falls, ID

3/5 CMS rating

OwnershipProprietary

CMS Certification Number130018

Location3100 Channing WayIdaho Falls, ID 83404 · Bonneville County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 15

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

MRS. ANNA L. ZOBELL NP-C

Nurse Practitioner (Family)