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ALTITUDE SPORT & SPINE PLLC
NPI 1992663595
Family Medicine - Sports Medicine in Idaho Falls, ID

Active since January 13, 2026
1582 ELK CREEK DR, IDAHO FALLS, ID 83404(208) 213-5256 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Altitude Sport & Spine Pllc NPPES

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

ALTITUDE SPORT & SPINE PLLC (NPI 1992663595) is a healthcare organization registered as a sports medicine in Idaho Falls, Idaho and active in the NPI registry since January 2026. The organization lists Joshua Sirucek, Owner, as its authorized official.

NPPES Registry Identity

NPI1992663595
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameALTITUDE SPORT & SPINE PLLC
Location Address1582 ELK CREEK DRIdaho Falls, ID 83404-8322
Mailing Address1582 Elk Creek DrIdaho Falls, ID 83404-8322 · (208) 213-5256
Phone(208) 213-5256
Organization SubpartNo
Authorized OfficialJoshua SirucekOwner · (208) 213-5256
Enumeration DateJanuary 13, 2026
NPPES CertifiedJanuary 12, 2026
✔ NPI 1992663595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
1582 ELK CREEK DR, Idaho Falls, ID 83404
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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)

Altitude Sport & Spine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Altitude Sport & Spine PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Benjamin Leishman, D.O.
Osteopathic Manipulative Medicine
NPI 1063862977
1582 ELK CREEK DR
Idaho Falls, ID 83404
(208) 881-0227
✔ PECOS✔ Accepts MedicareSame address
Josh Sirucek, D.O.
Emergency Medicine
NPI 1487066643
1582 ELK CREEK DR
Idaho Falls, ID 83404
(208) 213-5256
✔ 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 Altitude Sport & Spine PLLC's NPI number?

The NPI number for Altitude Sport & Spine PLLC is 1992663595. It was assigned to this organization in the NPPES registry on January 13, 2026.

Where is Altitude Sport & Spine PLLC located?

Altitude Sport & Spine PLLC is located at 1582 Elk Creek Dr, Idaho Falls, ID 83404. The listed phone number is (208) 213-5256.

What is Altitude Sport & Spine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Altitude Sport & Spine PLLC enrolled in Medicare?

Yes. Altitude Sport & Spine PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Altitude Sport & Spine PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Altitude Sport & Spine PLLC, in Emergency Medicine and Osteopathic Manipulative Medicine. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Altitude Sport & Spine PLLC accept?

Health plans from University of Utah Health Plans list Altitude Sport & Spine 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 Altitude Sport & Spine PLLC was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.