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INNOVATIVE MEDICAL IMAGING, PLLC
NPI 1962015776
Radiology - Diagnostic Radiology in Twin Falls, ID

Active since August 31, 2020
512 POLE LINE RD STE 1, TWIN FALLS, ID 83301(208) 735-5555(208) 735-5556 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 23, 2023, Aug 31, 2020 (2 updates tracked since 2020).

About Innovative Medical Imaging, Pllc NPPES

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

INNOVATIVE MEDICAL IMAGING, PLLC (NPI 1962015776) is a healthcare organization registered as a diagnostic radiology in Twin Falls, Idaho and active in the NPI registry since August 2020. The organization lists Stephan G Thiede, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1962015776
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameINNOVATIVE MEDICAL IMAGING, PLLC
Location Address512 POLE LINE RD STE 1Twin Falls, ID 83301-6367
Mailing AddressPo Box 1614Evansville, IN 47706-0016
Phone(208) 735-5555
Fax(208) 735-5556
Organization SubpartNo
Authorized OfficialStephan G ThiedeAuthorized Official · (541) 334-7550
Enumeration DateAugust 31, 2020
Last NPPES UpdateFebruary 12, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2024
✔ NPI 1962015776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
512 POLE LINE RD STE 1, Twin Falls, ID 83301
Open in Google Maps ↗

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 Moda Health Plan, Inc., PacificSource Health Plans, Select Health.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)

Innovative Medical Imaging, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

24

Medicare enrollment records show 24 clinicians reassign Medicare billing to Innovative Medical Imaging, PLLC, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Diagnostic Radiology22
Interventional Radiology1
Nurse Practitioner1

Nearest to this location (20)

See all 24
Jean Paul Colon Pons, M.D.
Diagnostic Radiology
NPI 1043654015
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Bernardo Isuani, MD
Diagnostic Radiology
NPI 1881630861
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Jonathan Jo, MD
Interventional Radiology
NPI 1225418361
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Marius Pakalniskis, M.D.
Diagnostic Radiology
NPI 1083928683
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Brandon Roller, M.D., PH.D.
Diagnostic Radiology
NPI 1083813844
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Alexander Schabel, MD
Diagnostic Radiology
NPI 1801978481
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Ryan Tade, M.D.
Diagnostic Radiology
NPI 1306266515
801 POLE LINE RD W
Twin Falls, ID 83301
(208) 814-1500
✔ PECOS✔ Accepts Medicare0.6 mi
Samuel Shaw, FNP-C
Nurse Practitioner
NPI 1073248787
1835 HARRISON ST N UNIT 16104
Twin Falls, ID 83301
(208) 431-3570
✔ PECOS✔ Accepts Medicare0.8 mi
Jeffrey Anderson, M.D.
Diagnostic Radiology
NPI 1194848697
445 HARLOW RD STE 200
Springfield, OR 97477
(541) 302-7771
✔ PECOS✔ Accepts Medicare442 mi
Robert Gunderman, MD
Diagnostic Radiology
NPI 1497787485
445 HARLOW RD SUITE #200
Springfield, OR 97477
(541) 681-8586
✔ PECOS✔ Accepts Medicare442 mi
Akshay Gupta, MD
Diagnostic Radiology
NPI 1326084377
445 HARLOW RD STE 200
Springfield, OR 97477
(541) 302-7771
✔ PECOS✔ Accepts Medicare442 mi
Jerrell Ingalls, MD
Diagnostic Radiology
NPI 1851517999
445 HARLOW RD STE 200
Springfield, OR 97477
(541) 302-7771
✔ PECOS✔ Accepts Medicare442 mi
Corey Orton, M.D.
Diagnostic Radiology
NPI 1659683928
445 HARLOW RD STE 200
Springfield, OR 97477
(541) 302-7771
✔ PECOS✔ Accepts Medicare442 mi
John Dohrman, MD
Diagnostic Radiology
NPI 1508030909
1200 HILYARD ST
Eugene, OR 97401
(541) 687-7135
✔ PECOS✔ Accepts Medicare445 mi
Jon Ekstrom, MD
Diagnostic Radiology
NPI 1407871163
1200 HILYARD ST STE 330
Eugene, OR 97401
(541) 687-7134
✔ PECOS✔ Accepts Medicare445 mi
Jonathan Sims, MD
Diagnostic Radiology
NPI 1124075122
1200 HILYARD ST STE 330
Eugene, OR 97401
(813) 974-2538
✔ PECOS✔ Accepts Medicare445 mi
Stephan Thiede, MD
Diagnostic Radiology
NPI 1346277399
1200 HILYARD ST
Eugene, OR 97401
(541) 687-7134
✔ PECOS✔ Accepts Medicare445 mi
David Tsai, MD
Diagnostic Radiology
NPI 1265478499
1200 HILYARD ST STE 330
Eugene, OR 97401
(541) 687-7134
✔ PECOS✔ Accepts Medicare445 mi
Erik Young, MD PHD
Diagnostic Radiology
NPI 1558484238
1200 HILYARD ST STE 330
Eugene, OR 97401
(541) 687-7134
✔ PECOS✔ Accepts Medicare445 mi
Dmitriy Kazimirko, M.D.
Diagnostic Radiology
NPI 1417397738
10 COBURG RD STE 300
Eugene, OR 97401
(541) 681-8595
✔ PECOS✔ Accepts Medicare445 mi
See all 24 clinicians

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 Innovative Medical Imaging, PLLC's NPI number?

The NPI number for Innovative Medical Imaging, PLLC is 1962015776. It was assigned to this organization in the NPPES registry on August 31, 2020.

Where is Innovative Medical Imaging, PLLC located?

Innovative Medical Imaging, PLLC is located at 512 Pole Line Rd Ste 1, Twin Falls, ID 83301. The listed phone number is (208) 735-5555.

What is Innovative Medical Imaging, PLLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Innovative Medical Imaging, PLLC enrolled in Medicare?

Yes. Innovative Medical Imaging, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Innovative Medical Imaging, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 3 Medicare specialties reassign their Medicare billing to Innovative Medical Imaging, PLLC. 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. The largest specialties are Diagnostic Radiology (22), Interventional Radiology (1) and Nurse Practitioner (1). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Innovative Medical Imaging, PLLC accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Select Health list Innovative Medical Imaging, PLLC 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 Innovative Medical Imaging, PLLC was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.