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MOUNTAIN CREST FOOT AND ANKLE PA
NPI 1932191996
Podiatrist in Idaho Falls, ID

Active since August 16, 2005
3652 WASHINGTON PKWY, IDAHO FALLS, ID 83404(208) 528-8700(208) 528-2802 Get Directions Write a Review

NPPES record last updated: December 6, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mountain Crest Foot And Ankle Pa NPPES

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

MOUNTAIN CREST FOOT AND ANKLE PA (NPI 1932191996) is a healthcare organization registered as a podiatrist in Idaho Falls, Idaho and active in the NPI registry since August 2005. The organization lists Timothy Roger Black, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1932191996
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameMOUNTAIN CREST FOOT AND ANKLE PA
Location Address3652 WASHINGTON PKWYIdaho Falls, ID 83404-7573
Mailing Address3652 Washington PkwyIdaho Falls, ID 83404-7573 · (208) 528-8700 · Fax (208) 528-2802
Phone(208) 528-8700
Fax(208) 528-2802
Organization SubpartNo
Authorized OfficialTimothy Roger BlackOwner/physician · (208) 528-8700
Enumeration DateAugust 16, 2005
Last NPPES UpdateDecember 6, 2010
✔ NPI 1932191996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in ID · P-169
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
3652 WASHINGTON PKWY, Idaho Falls, ID 83404
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Other Identifiers 4

Medicaid806462800ID
Medicare NSC4590880001ID
Medicare UPINU92156
Medicare ID-Type Unspecified1350919ID

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.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)

Mountain Crest Foot And Ankle Pa 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 Mountain Crest Foot And Ankle PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Timothy Black, DPM
Podiatry
NPI 1578753091
3652 WASHINGTON PKWY
Idaho Falls, ID 83404
(208) 528-8700
✔ PECOS✔ Accepts MedicareSame address

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 Mountain Crest Foot And Ankle PA's NPI number?

The NPI number for Mountain Crest Foot And Ankle PA is 1932191996. It was assigned to this organization in the NPPES registry on August 16, 2005.

Where is Mountain Crest Foot And Ankle PA located?

Mountain Crest Foot And Ankle PA is located at 3652 Washington Pkwy, Idaho Falls, ID 83404. The listed phone number is (208) 528-8700.

What is Mountain Crest Foot And Ankle PA's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Mountain Crest Foot And Ankle PA enrolled in Medicare?

Yes. Mountain Crest Foot And Ankle PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mountain Crest Foot And Ankle PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Mountain Crest Foot And Ankle PA. 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.

What insurance does Mountain Crest Foot And Ankle PA accept?

Health plans from University of Utah Health Plans list Mountain Crest Foot And Ankle PA 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 Mountain Crest Foot And Ankle PA was last updated on December 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.