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DR. IVAN D PETRICH DO
NPI 1639527096
Family Medicine in Mountain Home Afb, ID

Active since May 26, 2016PECOS Enrolled
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648(208) 828-7900 Get Directions Write a Review

NPPES record last updated: September 12, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 12, 2025, Jul 21, 2022, Dec 15, 2021 and 2 more (5 updates tracked since 2016).

About Dr. Ivan D Petrich Do NPPES

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

DR. IVAN D PETRICH DO (NPI 1639527096) is an individual family medicine provider in Mountain Home Afb, Idaho, licensed in North Carolina (2019-01392) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639527096
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. IVAN D PETRICHCredential: DO
Location Address90 HOPE DRMountain Home Afb, ID 83648-1057
Mailing Address90 Hope DrMountain Home Afb, ID 83648-1057 · (208) 828-7900
Phone(208) 828-7900
Sole ProprietorNo
Enumeration DateMay 26, 2016
Last NPPES UpdateSeptember 12, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2025
✔ NPI 1639527096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 2019-01392
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 ListedPreventive Medicine · Aerospace MedicineTaxonomy 2083A0100X · License 2019-01392 (NC)
90 HOPE DR, Mountain Home Afb, ID 83648
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ivan D Petrich Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83648 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 20

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

KIRSTY LYNN HOUSE IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
90 HOPE DR, 366TH MEDICAL GROUP
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-6806
JACQUELINE A SHAFER LCSW
Social Worker (Clinical)
90 HOPE DR
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-7531
CASEY ELIZABETH LYNCH WHNP-BC
Nurse Practitioner (Women's Health)
90 HOPE DR
MOUNTAIN HOME AFB, ID 83648
Elmore County (208) 828-6806
MR. DENNIS JACOB REUTER IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
90 HOPE DR
MOUNTAIN HOME AFB, ID 83648
Elmore County (360) 304-2048
DR. NATHAN TUAEFU PALMER M.D.
Family Medicine
90 HOPE DR
MOUNTAIN HOME AFB, ID 83648
Elmore County (907) 903-9212
MR. STEVE A. NEFF MSW
Counselor
90 HOPE DR, 366 MEDGRP (ACC)/FAMILY ADVOCACY
MOUNTAIN HOME A F B, ID 83648
Elmore County (208) 828-7520
DR. ERIC DOUGLAS NIELSEN O.D.
Optometrist
90 HOPE DR, OPTOMETRY CLINIC
MOUNTAIN HOME A F B, ID 83648
Elmore County (208) 828-7250
DR. JENNIFER LYNN HUDSON D.O.
Obstetrics & Gynecology
90 HOPE DR, 366 MEDICAL GROUP, WOMEN'S HEALTH
MOUNTAIN HOME A F B, ID 83648
Elmore County (208) 282-7567

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 Ivan Petrich's NPI number?

The NPI number for Ivan Petrich is 1639527096. It was assigned to this individual provider in the NPPES registry on May 26, 2016.

Where is Ivan Petrich located?

Ivan Petrich practices at 90 Hope Dr, Mountain Home Afb, ID 83648. The listed phone number is (208) 828-7900.

What is Ivan Petrich's specialty?

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

Is Ivan Petrich enrolled in Medicare?

Yes. Ivan Petrich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ivan Petrich was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.