NPI age
19 years
Enumerated 2006-08-19
● Active
Type 1 · Individual
Michael Jude Pankau, MD
Pankau is 1 of 15 pediatrics providers in Idaho Falls and 1 of 252 in Idaho.
Primary specialty
Pediatrics
Plus 1 subspecialty
Licensed in
ID, TX
2 states
Status
Active
No deactivations on record
Last NPPES update
2009-09-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 252 active pediatrics providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
State licenses
2 states
Top 73% — 27% of peers are multi-state
Subspecialties
0
34% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
3430 Washington Pkwy
Idaho Falls, ID 834047579
Mailing address
3430 Washington Pkwy
Idaho Falls, ID 834047579
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 0038900000 | |
| 05 (WY) | 110702000 | |
| 01 (ID) | 000010005951 | BLUE SHIELD |
| 05 (MT) | 0117402 | |
| 05 (WY) | 1285786046 | |
| 01 (ID) | 48157 | BLUE CROSS |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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