ELMER G DODGE JR. FNP
NPI 1508918236
Nurse Practitioner in Star, ID

Q: What is Elmer Dodge's NPI number?

The NPI number for Elmer Dodge is 1508918236. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Q: What is Elmer Dodge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Elmer Dodge was last updated on September 1, 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.

Active since January 16, 2007PECOS Enrolled

9858 W STATE ST, STAR, ID 83669(208) 286-0666(208) 286-0565 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Elmer G Dodge Jr. Fnp NPPES

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

ELMER G DODGE JR. FNP (NPI 1508918236) is an individual nurse practitioner in Star, Idaho, licensed in Idaho (NP-534A) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508918236

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameELMER G DODGE JR.Credential: FNP

Location Address9858 W STATE STStar, ID 83669-5210

Mailing AddressPo Box 44267Boise, ID 83711-0267 · (208) 286-0666 · Fax (208) 286-0565

Phone(208) 286-0666

Fax(208) 286-0565

Sole ProprietorNo

Enumeration DateJanuary 16, 2007

Last NPPES UpdateSeptember 1, 2020

NPPES CertifiedSeptember 1, 2020

✔ NPI 1508918236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in ID · NP-534A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License NP534A (ID)

9858 W STATE ST, Star, ID 83669

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Other Identifiers 3

Medicaid806045400ID

OtherNPQP7ID · Blue Cross Of Idaho

Other000010150031ID · Regence Blue Shield Of Id

Accepted Insurance

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

Elmer G Dodge Jr. Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Elmer Dodge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Black Canyon Medical Group PLLC

12 mi

Family Medicine

426 HIGHWAY 16
Emmett, ID 83617

Reassigned Medicare billing, Idaho enrollment
3 clinicians in this Medicare group

NPI 1811419708 (208) 365-2735

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83669 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.

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.

OWYHEE FAMILY MEDICINE PLLC

Family Medicine