Individual provider Active NPI

Todd M Waldmann, M.D.

  • Urology Physician
  • Meridian, ID
National Provider Identifier
1104877299
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M-7595 Issued in ID
Practice address
2855 E Magic View Dr
Meridian, ID 83642-6245
Phone
(208) 639-4900
Fax
(208) 639-4901
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X M-7595 ID Primary

Addresses

Primary practice location

2855 E Magic View Dr
Meridian, ID 83642-6245

Mailing address

2855 E Magic View Dr
Meridian, ID 83642-6245
Phone (208) 639-4900

Other identifiers 6

IdentifierTypeStateIssuer
000010004760OtherIDBLUE SHIELD BOISE
805249200MedicaidID
76711OtherIDBLUE CROSS MERIDIAN
B4893OtherIDBLUE CROSS BOISE
000010157306OtherIDBLUE SHIELD MERIDIAN
P00250287OtherIDRAILROAD MEDICARE

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
I20050817001134 ID Practitioner - Urology 1355371865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Oregon Health Sciences University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Urologic Institute PAGroup PAC ID 9537199039, 20 clinicians

Practice addresses (Care Compare)

2855 E Magic View Dr
Meridian, ID 83642-6245
Phone (208) 639-4900

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
78.29 of 100Reported as group
Quality
52.53
Promoting interoperability
100
Improvement activities
40
Cost
75.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Urologic Institute PA Urology CurrentSince Aug 1, 2005 Accepting new patients
Idaho Surgical, LLC PastSince May 1, 2019 Accepting new patients

Locations

333 N 1st St
Ste 100
Boise, ID 83702
Phone (208) 343-7736

222 N 2nd St
Ste 115
Boise, ID 83702
Phone (208) 336-3232

2855 E Magic View Dr
Meridian, ID 83642
Phone (208) 639-4900

890 N 6th E
Mt Home, ID 83647
Phone (208) 376-3591

6195 E Hunt Ave
Nampa, ID 83687
Phone (208) 639-4900

Interoperability endpoints

  • Direct secure messaging: twaldmann1564224@direct.trinity-health.org

Organizations & group practices 2

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 10

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1104877299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 E MAGIC VIEW DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426245",
            "telephone_number": "208-639-4900",
            "fax_number": "208-639-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 E MAGIC VIEW DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426245",
            "telephone_number": "208-639-4900",
            "fax_number": "208-639-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMANN",
        "first_name": "TODD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "M-7595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BOISE",
            "identifier": "000010004760",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805249200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MERIDIAN",
            "identifier": "76711",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BOISE",
            "identifier": "B4893",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD MERIDIAN",
            "identifier": "000010157306",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00250287",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.