TYSON SMITHERSEN FNP
NPI 1679233134
Nurse Practitioner - Family in Idaho Falls, ID

Q: What is Tyson Smithersen's NPI number?

The NPI number for Tyson Smithersen is 1679233134. It was assigned to this individual provider in the NPPES registry on December 26, 2021.

Q: What is Tyson Smithersen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tyson Smithersen was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since December 26, 2021PECOS EnrolledAccepts Medicare Assignment

3200 CHANNING WAY STE 206, IDAHO FALLS, ID 83404(208) 529-2230(208) 561-8061 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 6, 2024, Mar 23, 2023, Mar 3, 2022 and 1 more (4 updates tracked since 2021).

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About Tyson Smithersen Fnp NPPES

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

TYSON SMITHERSEN FNP (NPI 1679233134) is an individual family provider in Idaho Falls, Idaho, licensed in Idaho (2361278) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, is affiliated with Eastern Idaho Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1679233134

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameTYSON SMITHERSENCredential: FNP

Location Address3200 CHANNING WAY STE 206Idaho Falls, ID 83404-7546

Mailing Address3200 Channing Way Ste 206Idaho Falls, ID 83404-7546 · (208) 529-2230 · Fax (208) 561-8061

Phone(208) 529-2230

Fax(208) 561-8061

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 26, 2021

Last NPPES UpdateJanuary 15, 20254 updates tracked since enumeration

NPPES CertifiedJanuary 9, 2025

✔ NPI 1679233134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in ID · 2361278✔ Licensed in UT · 10808238-4405

3200 CHANNING WAY STE 206, Idaho Falls, ID 83404

Open in Google Maps ↗

Secondary Practice Locations 2

Location 11763 W Lunford LnRiverton, UT 84065-7451 · Phone (208) 680-8408

Location 22801 N Thanksgiving Way Ste 220Lehi, UT 84043-5492 · Phone (801) 477-6161

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Providence Health Plan, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tyson Smithersen Fnp 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.

PECOS PAC ID6608261854

PECOS Enrollment IDI20251114002423

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Eastern Idaho Regional Medical Center

Acute Care Hospitals · Idaho Falls, ID

3/5 CMS rating

OwnershipProprietary

CMS Certification Number130018

Location3100 Channing WayIdaho Falls, ID 83404 · Bonneville County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83404 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 13

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

DR. JHADE WOODALL MD

Plastic Surgery