NPI age
19 years
Enumerated 2006-06-20
● Active Type 2 · Organization
Southern Idaho Radiology PA
Southern Idaho Radiology PA is 1 of 248 radiology organizations in Idaho.
Primary specialty
Radiology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wasserstrom
President
Last NPPES update
2007-07-18
Source: monthly bulk 2026-05
How this organization compares
Across 248 active radiology providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
260 Falls Ave
Twin Falls, ID 833013370
Mailing address
Po Box 9649
Boise, ID 837074649
Authorized official
Robert Wasserstrom, M.D.
President
📞 2087341177
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Terry Buccambuso, M.D. Radiology NPI 1902842271
- Michael Holzer, M.D. Radiology NPI 1255361150
- Chad Nielson, D.C. Chiropractor NPI 1952458127
- Mark Taylor, DPT Physical Therapist NPI 1134374796
- Evan Thomas, M.D. Radiology NPI 1447284591
- Robert Wasserstrom, M.D. Radiology NPI 1982638037
- Jeremy Willes, PAC Physician Assistant NPI 1356314843
Specialties
-
Radiology PrimaryA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 248 Radiology providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- 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.