Tyler Roe, DO | |
1344 Hiland Ave Ste A, Burley, ID 83318 | |
(208) 678-7246 | |
Not Available |
Full Name | Tyler Roe |
---|---|
Gender | Male |
Speciality | Pain Management |
Experience | 11 Years |
Location | 1344 Hiland Ave Ste A, Burley, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710305768 | NPI | - | NPPES |
388203701 | Medicaid | TX | |
388203702 | Other | TX | CSHCN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | Q8621 (Texas) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | O-1201 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Cassia Regional Hospital | Burley, ID | Hospital |
Minidoka Memorial Hospital | Rupert, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Magic Valley Pain Specialists, Pllc | 8820484389 | 3 |
Entity Name | Minidoka Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134333495 PECOS PAC ID: 7315908894 Enrollment ID: O20041019001205 |
Entity Name | Minidoka Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679553531 PECOS PAC ID: 7315908894 Enrollment ID: O20050801000086 |
Entity Name | North Canyon Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609046671 PECOS PAC ID: 0941371439 Enrollment ID: O20090409000304 |
Entity Name | Pain & Spine Consultants |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902366834 PECOS PAC ID: 5395072946 Enrollment ID: O20190806001323 |
Entity Name | Magic Valley Pain Specialists, Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003564998 PECOS PAC ID: 8820484389 Enrollment ID: O20220408001697 |
Mailing Address | Practice Location Address |
---|---|
Tyler Roe, DO 1344 Hiland Ave Ste A, Burley, ID 83318-1564 Ph: (208) 678-7246 | Tyler Roe, DO 1344 Hiland Ave Ste A, Burley, ID 83318 Ph: (208) 678-7246 |