NPIMap

Individual provider Active NPI

Karl P Undesser, MD

  • Clinical Cardiac Electrophysiology Physician
  • Caldwell, ID
National Provider Identifier
1013961242
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
M6986 Issued in ID
Practice address
1906 Fairview Ave Ste 230
Caldwell, ID 83605-5432
Phone
(208) 795-5073
Fax
(208) 402-3181
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X M6986 ID Primary

Addresses

Primary practice location

1906 Fairview Ave Ste 230
Caldwell, ID 83605-5432

Mailing address

PO Box 742941
Atlanta, GA 30374-2941

Other identifiers 1

IdentifierTypeStateIssuer
1013961242MedicaidID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KARL.UNDESSER@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000258 ID Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9537167432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Texas Medical School at San Antonio, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Valley Medical Group Specialty Services LLCGroup PAC ID 5799901815, 6 clinicians

Practice addresses (Care Compare)

1906 Fairview Ave
Suite 230
Caldwell, ID 83605-5432
Phone (208) 459-0028

Hospital & facility affiliations

  • West Valley Medical Center Hospital, Caldwell, ID, CCN 130014
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Weiser Memorial Hospital Hospital, Weiser, ID, CCN 131307
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as individual
Quality
91.11
Improvement activities
40
Cost
69.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6986IDMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center, Inc. CurrentSince Apr 2, 2009 Accepting new patients
Boise Pathology Group P.a. Current Accepting new patients
North Canyon Medical Center Inc. Current Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Apr 2, 2009 Accepting new patients
Idaho Cardiology Associates PA Clinical Cardiac Electrophysiology Past Accepting new patients
Caldwell Internal Medicine Professional Association Past Accepting new patients
West Valley Professional Fee Billing, LLC Past Accepting new patients
Gooding County Hospital District Past Accepting new patients
OB-GYN Associates, PA PastSince Jan 1, 2009 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

1000 State St
McCall, ID 83638
Phone (208) 634-2221

520 S Eagle Rd
Ste 3104
Meridian, ID 83642
Phone (208) 373-1200

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/weismem-15d5bc1b
  • Direct secure messaging: karl.undesser@hca3.eclinicaldirectplus.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1013961242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742941",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055432",
            "telephone_number": "208-795-5073",
            "fax_number": "208-402-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDESSER",
        "first_name": "KARL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-01-27",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "ID",
            "license": "M6986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013961242",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KARL.UNDESSER@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1906 Fairview Ave Ste 230",
            "city": "Caldwell",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836055432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.