Individual provider Active NPI

Hadi Bhurgri, MD

  • Gastroenterology Physician
  • Ketchum, ID
National Provider Identifier
1124388947
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
9371944 Issued in ID
Practice address
100 Hospital Dr
Ketchum, ID 83340
Phone
(208) 727-8888
Fax
(208) 727-8889
NPI assigned
May 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 9371944 ID Primary
Gastroenterology Physician 207RG0100X 2016040197 MO

Addresses

Primary practice location

100 Hospital Dr
Ketchum, ID 83340

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 458-3581

Other practice location 1

1050 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-3580

Other practice location 2

150 Bergen St
Uh-I-248
Newark, NJ 07103-2496
Phone (973) 972-6000

Other identifiers 2

IdentifierTypeStateIssuer
000015401OtherMOMEDICARE
507013605MedicaidMO

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
I20250129001380 ID Practitioner - Gastroenterology 3173894052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Canyon Medical Center IncGroup PAC ID 0941371439, 73 clinicians

Practice addresses (Care Compare)

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

Hospital & facility affiliations

  • North Canyon Medical Center Hospital, Gooding, ID, CCN 131302

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy19
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9371944IDMDGastroenterology Physician
2016040197MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center Inc. CurrentSince Mar 15, 2025 Accepting new patients
St Lukes Clinic - Wood River LLC CurrentSince Mar 24, 2025 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Mar 15, 2025 Accepting new patients
Inland Cardiology Associates, P.S. Past Accepting new patients

Locations

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

718 Highway 30
Buhl, ID 83316
Phone (208) 543-4785

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

491 Heritage Dr
Jerome, ID 83338
Phone (208) 644-7500

Organizations & group practices 9

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 1

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": "1337990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1124388947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-3581",
            "fax_number": "573-202-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-727-8888",
            "fax_number": "208-727-8889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-3580",
            "fax_number": "573-202-2408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Bergen St",
            "address_2": "UH-I-248",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032496",
            "country_code": "US",
            "telephone_number": "973-972-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHURGRI",
        "first_name": "HADI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "9371944",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2016040197",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000015401",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507013605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchum, ID

Sources for this page

Verify at the official NPI Registry.