NPI age
19 years
Enumerated 2007-01-19
● Active Type 2 · Organization
Moscow Medical, P.A.
Moscow Medical, P.A. is 1 of 1691 family medicine organizations in Idaho.
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Cornish
Billing Manager
Last NPPES update
2009-03-31
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
19 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
213 N Main St
Moscow, ID 838432700
Mailing address
213 N Main St
Moscow, ID 838432700
Authorized official
Kathy Cornish
Billing Manager
📞 2087463653
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Michelle Brunke, LMSW Social Worker NPI 1043037633
- Jessica Cruz, MPAS, PA-C Physician Assistant NPI 1952942195
- Jordan Harlow, NP Nurse Practitioner NPI 1073303277
- Deborah Medel, N.P Nurse Practitioner NPI 1255510442
- Sara Presol, FNP-C Nurse Practitioner NPI 1205317856
- Rodger Robertson, O.D. Optometrist NPI 1265503320
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 133858 | MEDICARE RHC |
| 05 (ID) | 002262200 |
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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- 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.