P Praxis·MD
● Active Type 1 · Individual

Gary Earl Ellwein, MD

Pathology·Idaho Falls, ID· NPI 1063480804 · Enumerated 2006 · 20 years on NPI
Ellwein is 1 of 7 pathology providers in Idaho Falls and 1 of 44 in Idaho.
NPI age
20 years
Enumerated 2006-03-09
Primary specialty
Pathology
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2012-12-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 44 active pathology providers in Idaho.

NPI age
20 years
≈ at median (19 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
36% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-03Enumerated in NPPES
2006 2026

Where they practice

Practice location
3100 Channing Way
Idaho Falls, ID 834047533
📞 2085296050fax 2085297085
Mailing address
1820 E 17th St, Ste 230
Idaho Falls, ID 834046521
📞 2085299779fax 2085422756

Specialties

  • Pathology Primary
    A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses...
    ID license #M3265 taxonomy 207ZP0102X

Identifiers

TypeValueNotes
05 (ID) 003682000
01 (ID) 000010003940 REGENCE BLUE SHIELD OF ID
01 (ID) 32625 BLUE CROSS OF IDAHO

Practice context

Part of a multi-provider practice. 240 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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