Derek Mencer

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3113 W Rose Hill St
Boise, ID 83705-1651

Phone

(805) 230-3701

Fax

(805) 823-4462

NPI assigned

Nov 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Sunderlin Behavioral Interventions

  • Behavior Analyst
  • Boise, ID
  • NPI 1003258179
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1104581495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 W ROSE HILL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051651",
            "telephone_number": "805-230-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 W ROSE HILL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051651",
            "telephone_number": "805-230-3701",
            "fax_number": "805-823-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCER",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William B Mello Jr., LMSW
• Danielle Renee Melton, DPT
• Jeanne Melton, MSW
• Daniel L Meltzer, MD
• Evan Melville, DO
• Diana Menchaca, PH.D.
• Isabel Menchaca, LPC
• Kathie Claire Mendez-Shaw, CCC-SLP
• Yisel Mendieta-Chavez, LMSW
• Natalie Minette Mendoza- Lopez

• Behavior Technician in Boise, ID
• Providers in Boise, ID by specialty
• Behavior Technician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.