Blake Anderson, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Idaho Falls, Idaho. His current practice location is
3100 Channing Way, Idaho Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 227-2850.
Blake Anderson is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063271641.
Physician's Profile
Full Name | Blake Anderson |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3100 Channing Way, Idaho Falls, Idaho |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063271641
- Provider Enumeration Date: 03/18/2024
- Last Update Date: 06/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 9739620113
- Enrollment ID: I20240925003167
Medical Identifiers
Medical identifiers for Blake Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063271641 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | MRO-2400 (Idaho) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Anderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Blake Anderson, 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: () - | Blake Anderson, 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (208) 227-2850 |
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