Individual provider Active NPI

Ethan A Ferrel, MD

  • Surgery Physician
  • Meridian, ID
National Provider Identifier
1073010054
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9861565 Issued in ID
Practice address
520 S Eagle Rd Ste 1241
Meridian, ID 83642-6355
Phone
(208) 381-6930
Fax
(208) 381-6931
NPI assigned
Apr 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9861565 ID Primary

Addresses

Primary practice location

520 S Eagle Rd Ste 1241
Meridian, ID 83642-6355

Mailing address

3318 N Grandmill LN
Coeur D Alene, ID 83814-5689
Phone (208) 292-0445

Other practice location 1

3318 N Grandmill Ln
Coeur D Alene, ID 83814-5689
Phone (208) 292-0445

Other practice location 2

2003 Kootenai Health Way Ste 310
Coeur D Alene, ID 83814-6051
Phone (208) 625-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230921000162 NJ Practitioner - General Surgery 1355795618 Reassigns benefits to 1 organization
I20250310003148 ID Practitioner - General Surgery 1355795618 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2018
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
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians
North Idaho Endoscopy and Surgical Specialists PLLCGroup PAC ID 7315488715, 2 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

2003 Kootenai Health Way
Suite 310
Coeur D Alene, ID 83814-6051
Phone (208) 625-6900

3318 N Grandmill LN
Coeur D Alene, ID 83814-5689
Phone (208) 609-3945

520 S Eagle Rd
Meridian, ID 83642-6351

520 S Eagle Rd
Meridian, ID 83642-6355

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

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Oct 4, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Surgery CurrentSince Dec 15, 2024 Accepting new patients
North Idaho Endoscopy and Surgical Specialists, PLLC Surgery CurrentSince Oct 1, 2025 Accepting new patients
Kootenai Health, Inc. CurrentSince Oct 4, 2025 Accepting new patients
One Surgical Specialists Surgery CurrentSince Aug 1, 2023 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
Kootenai Health, Inc. Surgery Past Accepting new patients
Kootenai Health, Inc. Past Accepting new patients

Locations

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

100 E Warm Springs Ave
#B
Boise, ID 83712
Phone (208) 381-6930

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

3318 N Grandmill Ln
Coeur D Alene, ID 83814
Phone (208) 277-1060

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

2003 Kootenai Health Way
Ste 310
Coeur D Alene, ID 83814
Phone (208) 625-4470

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

9850 W St Lukes Dr
Ste 260
Nampa, ID 83687
Phone (208) 381-3915

90 Prospect Ave
Ste 1D
Hackensack, NJ 07601
Phone (201) 343-3433

2 Sears Dr
Ste 202
Paramus, NJ 07652
Phone (201) 343-3433

Organizations & group practices 8

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 4

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1073010054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 N GRANDMILL LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145689",
            "telephone_number": "208-292-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD STE 1241",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426355",
            "telephone_number": "208-381-6930",
            "fax_number": "208-381-6931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3318 N Grandmill Ln",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838145689",
            "country_code": "US",
            "telephone_number": "208-292-0445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2003 Kootenai Health Way Ste 310",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-4470",
            "fax_number": "208-625-4471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERREL",
        "first_name": "ETHAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "9861565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.