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GRAND TETON CHILD NEUROLOGY
NPI 1639322258
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Idaho Falls, ID

Active since October 28, 2008
2225 TETON PLZ STE B, IDAHO FALLS, ID 83404(208) 529-4300(208) 529-1627 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 17, 2021, Aug 12, 2021 (2 updates tracked since 2021).

About Grand Teton Child Neurology NPPES

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

GRAND TETON CHILD NEUROLOGY (NPI 1639322258) is a healthcare organization registered as a neurology with special qualifications in child neurology in Idaho Falls, Idaho and active in the NPI registry since October 2008. The organization lists Peter W Castellanos, Neurologist, as its authorized official.

NPPES Registry Identity

NPI1639322258
Entity TypeOrganization
Primary Taxonomy2084N0402X
Legal Business NameGRAND TETON CHILD NEUROLOGY
Location Address2225 TETON PLZ STE BIdaho Falls, ID 83404-6494
Mailing Address2225 Teton Plz Ste BIdaho Falls, ID 83404-6494 · (208) 529-4300 · Fax (208) 881-5121
Phone(208) 529-4300
Fax(208) 529-1627
Organization SubpartNo
Authorized OfficialPeter W CastellanosNeurologist · (208) 529-4300
Enumeration DateOctober 28, 2008
Last NPPES UpdateAugust 17, 20212 updates tracked since enumeration
NPPES CertifiedAugust 17, 2021
✔ NPI 1639322258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
2225 TETON PLZ STE B, Idaho Falls, ID 83404
Open in Google Maps ↗

Other Identifiers 2

Medicaid807968700ID
Other77234ID · Blue Cross Of Idaho

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, University of Utah Health Plans.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)

Grand Teton Child Neurology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Grand Teton Child Neurology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Peter Castellanos, MD
Neurology
NPI 1811991474
2225 TETON PLZ STE B
Idaho Falls, ID 83404
(208) 529-4300
✔ PECOS✔ Accepts MedicareSame address

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

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 Grand Teton Child Neurology's NPI number?

The NPI number for Grand Teton Child Neurology is 1639322258. It was assigned to this organization in the NPPES registry on October 28, 2008.

Where is Grand Teton Child Neurology located?

Grand Teton Child Neurology is located at 2225 Teton Plz Ste B, Idaho Falls, ID 83404. The listed phone number is (208) 529-4300.

What is Grand Teton Child Neurology's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Grand Teton Child Neurology enrolled in Medicare?

Yes. Grand Teton Child Neurology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Grand Teton Child Neurology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Neurology) reassigns their Medicare billing to Grand Teton Child Neurology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Grand Teton Child Neurology accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Grand Teton Child Neurology 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 Grand Teton Child Neurology was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.