Syringa Kooskia Clinic is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Kooskia, Idaho. The current practice location for Syringa Kooskia Clinic is 22 N Main St, Kooskia, Idaho. For appointments, you can reach them via phone at
(208) 926-4776. The mailing address for Syringa Kooskia Clinic is 607 W Main St, Grangeville, Idaho and phone number is (208) 983-1700.
Syringa Kooskia Clinic is licensed to practice in Idaho (license number 18). The clinic also participates in the medicare program and its
NPI number is 1497044333. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(208) 926-4776.
Primary Care Clinic Profile
| Full Name | Syringa Kooskia Clinic |
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| Speciality | Clinic/Center |
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| Location | 22 N Main St, Kooskia, Idaho |
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| Authorized Official Name and Position | Betty Watson (CFO) |
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| Authorized Official Contact | 2089831700 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Syringa Kooskia Clinic
607 W Main St
Grangeville
ID 83530-1345
Ph: (208) 983-1700 | Syringa Kooskia Clinic
22 N Main St
Kooskia
ID 83539
Ph: (208) 926-4776 |
NPI Details:
| NPI Number | 1497044333 |
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| Provider Enumeration Date | 03/31/2011 |
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| Last Update Date | 08/02/2022 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 6800707530 |
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| Medicare Enrollment ID | O20110324000253 |
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Medical Identifiers
Medical identifiers for Syringa Kooskia Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497044333 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QP2300X | Clinic/center - Primary Care | 18 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Syringa Kooskia Clinic acts as a billing entity for following providers:
| Provider Name | James Shen |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1518306372
PECOS PAC ID: 0749506038
Enrollment ID: I20221018002223 |
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