NPIMap

Individual provider Active NPI

Robert Perko, MD

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1043261803
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M7801 Issued in ID
Practice address
12273 W McMillan Rd
Boise, ID 83713-0555
Phone
(208) 367-6330
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M7801 ID Primary

Addresses

Primary practice location

12273 W McMillan Rd
Boise, ID 83713-0555

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170

Other identifiers 1

IdentifierTypeStateIssuer
805196300MedicaidID

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
I20041130000903 ID Practitioner - Family Practice 9133184286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12273 W McMillan Rd
Boise, ID 83713-0555
Phone (208) 302-5500

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions34
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7801IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 21, 2009 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Family Medicine CurrentSince Dec 21, 2009 Accepting new patients

Locations

12273 W McMillan Rd
Boise, ID 83713
Phone (208) 302-5500

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

315 E Elm St
Ste 100
Caldwell, ID 83605
Phone (208) 302-7100

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

520 S Eagle Rd
Ste 1241
Meridian, ID 83642
Phone (208) 288-2255

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

Interoperability endpoints

  • Direct secure messaging: rperko141709@direct.trinity-health.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
First Choice HospiceBoise, ID, CCN 131563 Hospice Contracted Managing Employee Nov 17, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 12

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1043261803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "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": "12273 W MCMILLAN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130555",
            "telephone_number": "208-367-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKO",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M7801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805196300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.