NPIMap

Individual provider Active NPI

Graham W Donald, M.D.

  • Vascular Surgery Physician
  • Boise, ID
National Provider Identifier
1043527286
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
M-14001 Issued in ID
Practice address
333 N 1St St Ste 280
Boise, ID 83702-6132
Phone
(208) 345-6545
Fax
(208) 345-1213
NPI assigned
Sep 9, 2010
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X M-14001 ID Primary

Addresses

Primary practice location

333 N 1St St Ste 280
Boise, ID 83702-6132

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866

Other practice location 1

6140 W Curtisian Ave
Ste 102
Boise, ID 83704
Phone (208) 302-2800

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
I20180713002755 ID Practitioner - Vascular Surgery 4082886106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Southern California Keck School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

333 N 1St St
Boise, ID 83702-6132

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 19, 2023 Accepting new patients
Saint Alphonsus Medical Center Nampa, Inc. CurrentSince Sep 1, 2018 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
Saint Alphonsus Regional Medical Center Inc Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

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

333 N 1st St
Ste 280
Boise, ID 83702
Phone (208) 345-6545

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

4400 E Flamingo Ave
Ste 100
Nampa, ID 83687
Phone (208) 302-2200

Interoperability endpoints

  • Direct secure messaging: gdonald1564240@direct.trinity-health.org

Organizations & group practices 4

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

Hospital & facility affiliations 6

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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1043527286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 1ST ST STE 280",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026132",
            "telephone_number": "208-345-6545",
            "fax_number": "208-345-1213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 W Curtisian Ave",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "83704",
            "country_code": "US",
            "telephone_number": "208-302-2800",
            "fax_number": "208-302-2825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALD",
        "first_name": "GRAHAM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "ID",
            "license": "M-14001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.