Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Matt Tannenbaum, MD

Anatomic Pathology & Clinical Pathology Physician in Idaho Falls, ID · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093783375

Verified

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Registry record

Entity type Individual (Type 1)

Name Matt Tannenbaum

Credential MD

Sex Male

Practice address 3100 Channing Way, Idaho Falls, ID, 83404

Phone (208) 529-6050

Fax (208) 529-7085

Enumeration date Mar 10, 2006

Last updated in NPPES Dec 27, 2012

Taxonomy & licenses

207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License M7775 (ID) Primary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
000010005388	Other	ID	REGENCE BLUE SHIELD ID
805449000	Medicaid	ID	-
32946	Other	ID	BLUE CROSS OF ID

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Matt Tannenbaum practice?

The practice location on file with NPPES is in Idaho Falls, ID. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Matt Tannenbaum?

The National Provider Identifier (NPI) for Matt Tannenbaum is 1093783375, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-12-27.