Individual provider Active NPI

James H Stewart, PHD, MD

  • Dermatology Physician
  • Boise, ID
National Provider Identifier
1104870567
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M6826 Issued in ID
Practice address
7733 W Emerald St
Boise, ID 83704
Phone
(208) 376-3220
Fax
(208) 322-7370
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X M6826 ID
Dermatology Physician 207N00000X M6826 ID Primary

Addresses

Primary practice location

7733 W Emerald St
Boise, ID 83704

Mailing address

7733 W Emerald St
Boise, ID 83704-9020
Phone (208) 376-3220

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
I20040831001379 ID Practitioner - Dermatology 9739168105 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6826IDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Aug 1, 2018 Accepting new patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Aug 1, 2018 Accepting new patients
Mountain West Derm - Blackhart PLLC Mohs-Micrographic Surgery Past Accepting new patients
Mountain West Derm - Blackhart PLLC Dermatology Past Accepting new patients

Locations

7733 W Emerald St
Boise, ID 83704
Phone (208) 376-4777

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1104870567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049020",
            "telephone_number": "208-376-3220",
            "fax_number": "208-322-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-376-3220",
            "fax_number": "208-322-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PHD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "M6826",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M6826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.