GUILLERMO MODAD (NPI# 1588982888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588982888 |
| Entity Type | Individual |
| Full Name | GUILLERMO MODAD |
| Credential | M.D. |
| Practice Address |
700 S Main St Moscow ID 83843-3046 |
| Practice Telephone | 2088824511 |
| Practice Fax Number | 2088836580 |
| Mailing Telephone | 2088836359 |
| Mailing Fax Number | 2088836580 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2019-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | M-12525 | ID | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | M-12525 | ID | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11234 Anderson St, Graduate Medical Education Office Cp 21005, Loma Linda, CA 923542804 | 9095588131 |
| Street Address |
700 S MAIN ST |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720687031 | Panhandle Anesthesia Associates of Moscow | Nurse Anesthetist, Certified Registered | 700 S Main St, Moscow, ID 83843-3046 | 2020-10-19 |
| 1962015149 | James Lee Hug | Nurse Anesthetist, Certified Registered | 700 S Main St, Moscow, ID 83843-3046 | 2020-08-26 |
| 1720616188 | Kaylee Drenker | Pharmacist | 700 S Main St, Moscow, ID 83843-3046 | 2020-03-31 |
| 1083245377 | Jill Lynn Lawrence | Massage Therapist | 700 S Main St, Moscow, ID 83843-3056 | 2020-01-27 |
| 1932769700 | Gritman Medical Center Inc | Internal Medicine | 700 S Main St, Moscow, ID 83843-3046 | 2019-06-14 |
| 1669975207 | Colleen Cochran | Pharmacist | 700 S Main St, Moscow, ID 83843-3056 | 2018-03-09 |
| 1427566751 | Duane Dale | Speech-Language Pathologist | 700 S Main St, Moscow, ID 83843-3056 | 2018-01-22 |
| 1962913061 | Lori Marie Mages | Physical Therapist | 700 S Main St, Moscow, ID 83843-3056 | 2017-10-16 |
| 1245740638 | Kristen Topliff | Physical Therapist | 700 S Main St, Moscow, ID 83843-3056 | 2017-10-11 |
| 1124547401 | Dorothy Plaza | Registered Nurse | 700 S Main St, Moscow, ID 83843-3056 | 2017-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
| 1790343580 | Snake River Hospitalists, LLC | Hospitalist | 2325 Coronado St, Idaho Falls, ID 83404-7407 | 2019-06-05 |
| 1225564925 | Bryce L Arnold | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2017-05-02 |
| 1740715507 | Santibanez Aguirre PC | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2017-04-28 |
| 1528593381 | Lauren Franklin | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706 | 2017-04-28 |
| 1114389665 | Farah Esther Vega | Hospitalist | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2016-03-23 |
| 1790150514 | Pocatello Inpatient Services Pllc | Hospitalist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2015-12-04 |
| 1285014118 | Lyon Medical LLC | Hospitalist | 3080 E Gentry Way Ste 100, Meridian, ID 83642-3060 | 2015-06-05 |
| 1902285257 | Kanan Silvas | Hospitalist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-05-20 |
| 1780078626 | Hinah Gul Parker | Hospitalist | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.