Individual provider Active NPI

Christopher Desutter, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Boise, ID
National Provider Identifier
1104473883
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
M-16740 Issued in ID
Practice address
1075 N Curtis Rd Ste 300
Boise, ID 83706-1348
Phone
(208) 302-3100
Fax
(208) 302-3155
NPI assigned
Aug 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 58450 AZ
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 58450 AZ
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X M-16740 ID Primary

Addresses

Primary practice location

1075 N Curtis Rd Ste 300
Boise, ID 83706-1348

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 367-5170

Other practice location 1

9321 W Thomas Rd Ste 205
Phoenix, AZ 85037-3392
Phone (866) 974-2673

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826000987 ID Practitioner - Orthopedic Surgery 0547590549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alberta, Faculty of Medicine, 2013
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)

1055 N Curtis
Boise, ID 83706-1309

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

1075 N Curtis Rd
Boise, ID 83706-1348

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58450AZMDOrthopaedic Foot and Ankle Surgery Physician
M-16740IDMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2022 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

1075 N Curtis Rd
Ste 300
Boise, ID 83706
Phone (208) 323-2600

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

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

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

Interoperability endpoints

  • Direct secure messaging: cdesutter2129079@direct.trinity-health.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 9

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": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1104473883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N CURTIS RD STE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061348",
            "telephone_number": "208-302-3100",
            "fax_number": "208-302-3155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9321 W Thomas Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373392",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESUTTER",
        "first_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-19",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "58450",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "AZ",
            "license": "58450",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "ID",
            "license": "M-16740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.