NPI age
4 years
Enumerated 2022-03-10
● Active Type 2 · Organization
Magic Valley Pain Specialists, Pllc
Magic Valley Pain Specialists, Pllc is 1 of 29 anesthesiology organizations in Idaho.
Primary specialty
Anesthesiology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Roe
Owner
Last NPPES update
2022-09-27
Source: monthly bulk 2026-05
How this organization compares
Across 29 active anesthesiology providers in Idaho.
NPI age
4 years
↓ 12 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-03Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
1344 Hiland Ave Ste A
Burley, ID 833181564
Mailing address
Po Box 50979
Idaho Falls, ID 834050979
Authorized official
Tyler C Roe, DO
Owner
📞 2086787246
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Joseph Petersen Specialist NPI 1225105604
- Tyler Roe, DO Anesthesiology NPI 1710305768
Specialties
-
Anesthesiology PrimaryAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs...
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.