NPIMap

Individual provider Active NPI

Kaitlin C Neary, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Boise, ID
National Provider Identifier
1053609073
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
16821 Issued in NV
Practice address
8950 W Emerald St Ste 168
Boise, ID 83704-8296
Phone
(208) 321-1209
Fax
(208) 321-1211
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 16821 NV Primary
Orthopaedic Surgery Physician 207X00000X 6556 NE
Orthopaedic Surgery Physician 207X00000X 16821 NV

Addresses

Primary practice location

8950 W Emerald St Ste 168
Boise, ID 83704-8296

Mailing address

8950 W Emerald St Ste 168
Boise, ID 83704-8296
Phone (208) 321-1209

Other identifiers 2

IdentifierTypeStateIssuer
13885664OtherCAQH
1053609073MedicaidNV

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
I20170825003041 ID Practitioner - Orthopedic Surgery 4284866252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catalyst Orthopaedic and Sports Medicine Institute LLCGroup PAC ID 3870932536, 2 clinicians

Practice addresses (Care Compare)

8950 W Emerald St
Suite 168
Boise, ID 83704-8296
Phone (208) 321-1209

Hospital & facility affiliations

  • Treasure Valley Hospital Hospital, Boise, ID, CCN 130063
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S McCall Hospital, McCall, ID, CCN 131312
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue11
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6556NEMDGeneral Practice Dentistry
16821NVMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst Orthopaedic & Sports Medicine Institute LLC Orthopaedic Surgery CurrentSince Apr 15, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Aug 1, 2017 Accepting new patients
St Lukes Regional Medical Center PastSince Aug 1, 2017 Accepting new patients

Locations

8950 W Emerald St
Ste 168
Boise, ID 83704
Phone (208) 321-1209

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

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

3399 E Louise Dr
Ste 200
Meridian, ID 83642

Interoperability endpoints

  • Direct secure messaging: kneary87419@direct.slhs.org

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 10

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1053609073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST STE 168",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048296",
            "telephone_number": "208-321-1209",
            "fax_number": "208-321-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST STE 168",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048296",
            "telephone_number": "208-321-1209",
            "fax_number": "208-321-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEARY",
        "first_name": "KAITLIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2024-04-22",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NV",
            "license": "16821",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NE",
            "license": "6556",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "16821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13885664",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053609073",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.