Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Altitude Sport & Spine PLLC

Organization Sports Medicine (Family Medicine) Physician · NPI 1992663595

Altitude Sport & Spine PLLC is a Sports Medicine (Family Medicine) Physician in Idaho Falls, Idaho. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1582 Elk Creek Dr
Idaho Falls, ID 83404-8322
Phone: (208) 213-5256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1992663595
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Sirucek — Owner · (208) 213-5256
NPI enumeratedJanuary 13, 2026
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 12, 2026
Mailing address1582 Elk Creek Dr, Idaho Falls, ID 83404-8322

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