DR. BRUCE E. GOLLUB M.D.
NPI 1508855917
Family Medicine in Twin Falls, ID

Q: What is Bruce Gollub's NPI number?

The NPI number for Bruce Gollub is 1508855917. It was assigned to this individual provider in the NPPES registry on October 18, 2005.

Q: What is Bruce Gollub's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Bruce Gollub was last updated on November 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 October 18, 2005PECOS EnrolledAccepts Medicare Assignment

775 POLE LINE RD W STE 103, TWIN FALLS, ID 83301(208) 814-8375(208) 814-8376 Get Directions Write a Review

NPPES record last updated: November 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Bruce E. Gollub M.d. NPPES

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

DR. BRUCE E. GOLLUB M.D. (NPI 1508855917) is an individual family medicine provider in Twin Falls, Idaho, licensed in Idaho (M-17332) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1508855917

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. BRUCE E. GOLLUBCredential: M.D.

Location Address775 POLE LINE RD W STE 103Twin Falls, ID 83301-5819

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 814-8375

Fax(208) 814-8376

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1979

Enumeration DateOctober 18, 2005

Last NPPES UpdateNovember 30, 2023

NPPES CertifiedNovember 30, 2023

✔ NPI 1508855917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ID · M-17332✔ Licensed in NM · 80-158

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 80-158 (NM)

775 POLE LINE RD W STE 103, Twin Falls, ID 83301

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1660 2nd Ave. S. Apt AKetchum, ID 83340 · Phone (208) 622-3180 · Fax (833) 795-1981

Location 2401 Botulph LnSanta Fe, NM 87505-6912 · Phone (505) 983-8387 · Fax (505) 820-2733

Other Identifiers 1

Medicaid22491NM

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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

Dr. Bruce E. Gollub M.d. 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 ID941464986

PECOS Enrollment IDI20231019002085, I20231220003523

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.

Hospital Affiliations CMS Care Compare 2

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

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130002

Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County

Emergency services Birthing friendly

St Luke's Wood River Medical Center

Critical Access Hospitals · Ketchum, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131323

Location100 Hospital DriveKetchum, ID 83340 · Blaine County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83301 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers16 claims20 services$90.35 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

EMILY NICOLE MONTAGUE CNP

Nurse Practitioner (Family)