PEDIATRIC NEUROLOGY - IDAHO FALLS
NPI 1669918769
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Idaho Falls, ID
About Pediatric Neurology - Idaho Falls NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEDIATRIC NEUROLOGY - IDAHO FALLS (NPI 1669918769) 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 January 2017. The organization lists Edward Clark, Department Chair, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Accepted 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)
Pediatric Neurology - Idaho Falls is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Pediatric Neurology - Idaho Falls, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (12)
Salt Lake City, UT 84113
Salt Lake City, UT 84113
Philadelphia, PA 19104
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 University Of Utah Pediatric Services's NPI number?
The NPI number for University Of Utah Pediatric Services is 1669918769. It was assigned to this organization in the NPPES registry on January 12, 2017. The provider is doing business as Pediatric Neurology - Idaho Falls.
Where is University Of Utah Pediatric Services located?
University Of Utah Pediatric Services is located at 1645 Pancheri Dr, Idaho Falls, ID 83402. The listed phone number is (208) 227-1460.
What is University Of Utah Pediatric Services'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 University Of Utah Pediatric Services enrolled in Medicare?
Yes. University Of Utah Pediatric Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through University Of Utah Pediatric Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 3 Medicare specialties reassign their Medicare billing to University Of Utah Pediatric Services. 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. The largest specialties are Pediatric Medicine (10), Orthopedic Surgery (1) and Urology (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does University Of Utah Pediatric Services accept?
Health plans from Molina Healthcare and University of Utah Health Plans list University Of Utah Pediatric Services 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 University Of Utah Pediatric Services was last updated on May 21, 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.
# Pediatric Neurology - Idaho Falls · NPI 1669918769
Neurology with Special Qualifications in Child Neurology organization in Idaho Falls, Idaho. Organization record, active in the CMS NPPES registry since January 12, 2017.
## Identity
- **NPI:** 1669918769 (Entity type: Organization)
- **Enumerated:** January 12, 2017
- **Primary specialty:** Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology · taxonomy 2084N0402X
- **Legal business name:** University Of Utah Pediatric Services
- **Organization subpart:** Yes (part of University Of Utah Pediatric Services)
- **Authorized official:** Edward Clark, DEPARTMENT CHAIR
## Practice location
- **Address:** 1645 PANCHERI DR, Idaho Falls, ID 83402-3169
- **Phone:** (208) 227-1460
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Pediatric Medicine (10), Orthopedic Surgery (1), Urology (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 21, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1669918769) · Data from the CMS NPPES public registry.