MOOSE CREEK ANESTHESIA PC
NPI 1922990035
Nurse Anesthetist, Certified Registered in Idaho Falls, ID

Q: What is Moose Creek Anesthesia PC's NPI number?

The NPI number for Moose Creek Anesthesia PC is 1922990035. It was assigned to this organization in the NPPES registry on July 15, 2025.

Q: What is Moose Creek Anesthesia PC's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since July 15, 2025

3925 WASHINGTON PKWY, IDAHO FALLS, ID 83404(208) 201-4973 Get Directions Write a Review

NPPES record last updated: November 6, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Moose Creek Anesthesia Pc NPPES

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

MOOSE CREEK ANESTHESIA PC (NPI 1922990035) is a healthcare organization registered as a nurse anesthetist, certified registered in Idaho Falls, Idaho and active in the NPI registry since July 2025. The organization maintains a secondary practice location in Rexburg and lists Teresa Tegan, Credentialing & Billing, as its authorized official.

NPPES Registry Identity

NPI1922990035

Entity TypeOrganization

Primary Taxonomy367500000X

Legal Business NameMOOSE CREEK ANESTHESIA PC

Location Address3925 WASHINGTON PKWYIdaho Falls, ID 83404-7596

Mailing Address5341 Tildy LnIdaho Falls, ID 83401-6038 · (208) 734-7362 · Fax (208) 733-9463

Phone(208) 201-4973

Organization SubpartNo

Authorized OfficialTeresa TeganCredentialing & Billing · (208) 734-7362

Enumeration DateJuly 15, 2025

Last NPPES UpdateNovember 6, 2025

NPPES CertifiedNovember 6, 2025

✔ NPI 1922990035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

3925 WASHINGTON PKWY, Idaho Falls, ID 83404

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Secondary Practice Location 1

Location 123 Sawtelle AveRexburg, ID 83440-1499 · Phone (208) 734-7362

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moose Creek Anesthesia Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Moose Creek Anesthesia PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Travis Pickett, CRNA

Certified Registered Nurse Anesthetist (CRNA)

NPI 1376622894

2325 CORONADO ST
Idaho Falls, ID 83404

(208) 557-2700

✔ Accepts Medicare0.8 mi

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 Moose Creek Anesthesia PC's NPI number?

The NPI number for Moose Creek Anesthesia PC is 1922990035. It was assigned to this organization in the NPPES registry on July 15, 2025.

Where is Moose Creek Anesthesia PC located?

Moose Creek Anesthesia PC is located at 3925 Washington Pkwy, Idaho Falls, ID 83404. The listed phone number is (208) 201-4973.

What is Moose Creek Anesthesia PC's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Moose Creek Anesthesia PC enrolled in Medicare?

Yes. Moose Creek Anesthesia PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Moose Creek Anesthesia PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Certified Registered Nurse Anesthetist (CRNA)) reassigns their Medicare billing to Moose Creek Anesthesia PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Moose Creek Anesthesia PC was last updated on November 6, 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.