P Praxis·MD
● Active Type 1 · Individual

DR. Ananda Walaliyadda, M.D.

Specialist·Pocatello, ID· NPI 1497747703 · Enumerated 2005 · 20 years on NPI
Walaliyadda is 1 of 13 specialist providers in Pocatello and 1 of 305 in Idaho.
NPI age
20 years
Enumerated 2005-08-22
Primary specialty
Specialist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-06-29
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 305 active specialist providers in Idaho.

NPI age
20 years
↑ 2 yr above median (18 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
0
11% of peers hold subspecialties

NPI lifetime · 2005 → 2026

2005-08Enumerated in NPPES
2005 2026

Where they practice

Practice location
1448 E Center St, Suite E
Pocatello, ID 832014132
📞 2082341300fax 2082341333
Mailing address
1448 E Center St, Suite E
Pocatello, ID 832014132
📞 2082341300fax 2082341333

Specialties

  • Specialist Primary
    An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
    ID license #M8731 taxonomy 174400000X

Identifiers

TypeValueNotes
01 (ID) J9521 BLUE CROSS

Practice context

Part of a multi-provider practice. 4 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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