TAVISH RONALD NELSON CRNA
NPI 1679215958
Nurse Anesthetist, Certified Registered in Pocatello, ID
About Tavish Ronald Nelson Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TAVISH RONALD NELSON CRNA (NPI 1679215958) is an individual nurse anesthetist, certified registered in Pocatello, Idaho, licensed in Utah (153255) and active in the NPI registry since April 2022. He is affiliated with Portneuf Medical Center and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tavish Ronald Nelson Crna 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.
Medicare Billing Reassignment
Medicare enrollment records show Tavish Nelson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Pocatello, ID 83201
- Reassigned Medicare billing, Idaho enrollment
- 53 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Portneuf Medical Center
Acute Care Hospitals · Pocatello, IDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
POCATELLO, ID 83201
POCATELLO, ID 83201
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 Tavish Nelson's NPI number?
The NPI number for Tavish Nelson is 1679215958. It was assigned to this individual provider in the NPPES registry on April 8, 2022.
Where is Tavish Nelson located?
Tavish Nelson practices at 777 Hospital Way, Pocatello, ID 83201. The listed phone number is (208) 239-1000.
What is Tavish Nelson's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Tavish Nelson enrolled in Medicare?
Yes. Tavish Nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tavish Nelson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tavish Nelson reassigns Medicare benefits to Northstar Anesthesia Of Idaho PLLC (Pocatello, ID). The 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 Tavish Nelson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tavish Nelson accept?
Health plans from Moda Health Plan, Inc. list Tavish Nelson 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.
Is Tavish Nelson affiliated with any hospitals?
According to CMS data, Tavish Nelson is affiliated with Portneuf Medical Center.
When was this NPI record last updated?
The NPPES record for Tavish Nelson was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Tavish Ronald Nelson, CRNA · NPI 1679215958
Nurse Anesthetist, Certified Registered physician in Pocatello, Idaho. Individual provider, active in the CMS NPPES registry since April 8, 2022.
## Identity
- **NPI:** 1679215958 (Entity type: Individual)
- **Enumerated:** April 8, 2022
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 153255 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 777 HOSPITAL WAY, Pocatello, ID 83201-5175
- **Phone:** (208) 239-1000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Northstar Anesthesia Of Idaho PLLC (NPI 1912686882, Pocatello, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** May 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679215958) · Data from the CMS NPPES public registry.