JOHN P LUNDEBY MD
NPI 1720190796
Surgery in Coeur D Alene, ID
About John P Lundeby Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN P LUNDEBY MD (NPI 1720190796) is an individual surgery provider in Coeur D Alene, Idaho, licensed in Idaho (M6914) and active in the NPI registry since August 2006. He has opted out of Medicare through February 27, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
John P Lundeby Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 27, 2018 through February 27, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83814 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 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COEUR D ALENE, ID 83814
COEUR D ALENE, ID 83814
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 John Lundeby's NPI number?
The NPI number for John Lundeby is 1720190796. It was assigned to this individual provider in the NPPES registry on August 31, 2006.
Where is John Lundeby located?
John Lundeby practices at 608 Northwest Blvd Suite 301, Coeur D Alene, ID 83814. The listed phone number is (208) 664-4940.
What is John Lundeby's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is John Lundeby enrolled in Medicare?
No. John Lundeby has opted out of Medicare through February 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for John Lundeby was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# John P Lundeby, MD · NPI 1720190796
Surgery physician in Coeur D Alene, Idaho. Individual provider, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1720190796 (Entity type: Individual)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** M6914 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 608 NORTHWEST BLVD, SUITE 301, Coeur D Alene, ID 83814-2174
- **Phone:** (208) 664-4940 · **Fax:** (208) 664-5345
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 27, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicaid 807104000 (ID); Medicare UPIN G31354 (ID); Medicare ID-Type Unspecified 1379051 (ID)
---
Source: [NPI Profile](https://npiprofile.com/npi/1720190796) · Data from the CMS NPPES public registry.