Individual provider Active NPI

Mayra Moran, AUD

  • Audiologist
  • Boise, ID
National Provider Identifier
1023993607
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5381309 Issued in ID
Practice address
6094 W Emerald St
Boise, ID 83704-8855
Phone
(208) 302-1000
Fax
(208) 302-1035
NPI assigned
Aug 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 14226902-4101 UT
Audiologist 231H00000X 5381309 ID Primary

Addresses

Primary practice location

6094 W Emerald St
Boise, ID 83704-8855

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1716 US 40 Hwy
Heber City, UT 84032
Phone (801) 804-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251027003973 UT Practitioner - Qualified Audiologist 0042709487 Reassigns benefits to 1 organization
I20260420002404 ID Practitioner - Qualified Audiologist 0042709487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603

6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5381309IDMDAudiologist
14226902-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Ear,Nose, and Throat Specialists LLC CurrentSince Jul 31, 2025 Accepting new patients

Locations

756 E 12200 S
Draper, UT 84020
Phone (801) 833-0579

1716 N Highway 40
Ste 100
Heber City, UT 84032

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 2

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 5

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": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1023993607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6094 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048855",
            "telephone_number": "208-302-1000",
            "fax_number": "208-302-1035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 US 40 Hwy",
            "address_purpose": "LOCATION",
            "city": "Heber City",
            "state": "UT",
            "postal_code": "84032",
            "country_code": "US",
            "telephone_number": "801-804-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MAYRA",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "14226902-4101",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "5381309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.