Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Tony C Roisum MD PA

Family Medicine Physician in Idaho Falls, ID · enumerated 2006 · authorized official Jacqueline Kelsey, Office Manager.

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

National Provider Identifier

1124115944

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Tony C Roisum MD PA

Other name <Unavail>

Practice address 3360 Washington Pkwy, Suite 1, Idaho Falls, ID, 83404

Phone (208) 524-3416

Fax (208) 524-3138

Enumeration date Oct 5, 2006

Last updated in NPPES Jan 16, 2026

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License M7389 (ID) Primary

207QS0010X Sports Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians · License M7389 (ID) Secondary

Authorized official

Name Jacqueline Kelsey

Title Office Manager

Phone (208) 524-3416

Other identifiers

Identifier	Type	State	Issuer
000010004286	Other	ID	BLUE SHIELD
B5824	Other	-	BLUE CROSS
DJ475	Other	ID	BLUE CROSS
119166700	Medicaid	WY	-
185461600	Other	ID	US DEPT OF LABOR
502862456001	Medicaid	UT	-
23397	Other	-	BLUE SHIELD
805076700	Medicaid	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 is Tony C Roisum MD PA located?

The practice location on file with NPPES is in Idaho Falls, ID.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2026-01-16. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Alan Jensen Medical Physician Assistant · Idaho Falls, ID NPI 1821370461

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-01-16.