Active NPI
Timothy A Bialobrzeski, D.O.
- Pediatric Anesthesiology Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- O-0626
- Practice address
- 338 E Bannock St
Boise, ID 83712-6207 - Phone
- (208) 336-0895
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 936767 | MI | |
| Anesthesiology Physician | 207L00000X | O-0626 | ID | |
| Pediatric Anesthesiology Physician | 207LP3000X | O-0626 | ID | Primary |
Addresses
Primary practice location
338 E Bannock St
Boise, ID 83712-6207
Mailing address
12661 N Schicks Ridge Rd
Boise, ID 83714-9456
Phone (208) 908-6224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
338 E Bannock St
Boise, ID 83712-6207
Phone (208) 336-0895
Hospital & facility affiliations
- St Luke'S Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-0626 | ID | MD | Anesthesiology Physician |
| 936767 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Boise, P.a. | Current | Accepting new patients |
Locations
338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895
2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895
Organizations & group practices 1
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.
-
- Specialist
- Boise, ID
- NPI 1033147467
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1104034438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12661 N SCHICKS RIDGE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837149456",
"telephone_number": "208-908-6224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "338 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126207",
"telephone_number": "208-336-0895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIALOBRZESKI",
"first_name": "TIMOTHY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "936767",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "O-0626",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "ID",
"license": "O-0626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.