NPIMap

Individual provider Active NPI

Braden Lawrence, MD

  • Internal Medicine Physician
  • Boise, ID
National Provider Identifier
1104454123
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M-16829 Issued in ID
Practice address
10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone
(208) 302-5900
Fax
(208) 302-5955
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M-16829 ID Primary

Addresses

Primary practice location

10583 W Lake Hazel Rd
Boise, ID 83709-6326

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 302-9342

Other practice location 1

85 S Middleton Rd
Nampa, ID 83651
Phone (208) 381-4100

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
I20230731001334 ID Practitioner - Internal Medicine 0345601993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone (208) 302-5900

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16829IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jul 11, 2023 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Feb 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 1, 2026 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

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

1000 E Park Blvd
Ste 120
Boise, ID 83712
Phone (208) 381-4100

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

10583 W Lake Hazel Rd
Boise, ID 83709
Phone (208) 302-5900

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

85 S Middleton Rd
Nampa, ID 83651
Phone (208) 381-4100

Organizations & group practices 6

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 8

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1104454123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-302-9342",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10583 W LAKE HAZEL RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096326",
            "telephone_number": "208-302-5900",
            "fax_number": "208-302-5955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 S Middleton Rd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "83651",
            "country_code": "US",
            "telephone_number": "208-381-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "BRADEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-16829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.