NPI age
20 years
Enumerated 2006-04-27
● Active
Type 1 · Individual
Samuel L. Zuckerman, M.D.
Zuckerman is 1 of 2 pediatrics providers in Idaho Falls and 1 of 9 in Idaho.
Primary specialty
Pediatrics
Plus 2 subspecialties
Licensed in
ID, TX
2 states
Status
Active
No deactivations on record
Last NPPES update
2020-12-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 9 active pediatrics providers in Idaho.
NPI age
20 years
≈ at median (19 yr)
State licenses
2 states
Top 66% — 33% of peers are multi-state
Subspecialties
1
In the 44% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-04Enumerated in NPPES
2006
2026
Where they practice
Practice location
Mountain Neonatology Llc, 3100 Channing Way
Idaho Falls, ID 834047533
Mailing address
3100 Channing Way
Idaho Falls, ID 834047533
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
1400 S Coulter St
Amarillo, TX 791061786
Location 3
315 N San Saba Ste 1135
San Antonio, TX 782073255
Specialties
-
Pediatrics PrimaryA pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both...
-
AnesthesiologyAn anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs of infants and children. A pediatric anesthesiologist generally provides services...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 132776910 | |
| 05 (OH) | 200102900 A | |
| 05 (NM) | 33787336 | |
| 05 (TX) | 132776912 | |
| 05 (TX) | 132776911 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No 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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