Derek Ryan McDowell, DO
Individual provider Active NPI Hospitalist Physician · Boise, ID
NPI 1083110712 · NPPES record last updated Nov 23, 2021
Key facts
- NPI
- 1083110712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- O-1491 (ID)
- Practice address
- 190 E Bannock St
Boise, ID 83712-6241 - Phone
- (208) 814-4100
- NPI assigned
- Apr 2, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic LLC
Practice addresses (Care Compare)
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-1000
Hospital & facility affiliations
- Horizon Hospice Magic Valley
- St Lukes Magic Valley Medical Center
- St Luke'S Wood River Medical Center
- St Luke'S Regional Medical Center
- North Canyon Medical Center
- Minidoka Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.09 of 100
- Quality
- 77.1
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.19
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211201002036 | ID | Practitioner - Hospitalist | 1759639834 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-1491 | ID | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Clinic LLC | Current |
Accepting new patients | |
| St Luke'S Magic Valley Regional Medical Center LTD | Past | Accepting new patients | |
| St. Luke'S Magic Valley Regional Medical Center, LTD. | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000
746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | O-1491 | ID | Yes |
Addresses
Primary practice location
190 E Bannock St
Boise, ID 83712-6241
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.