Active NPI
Stephanie Marria, BSN
- Pediatric Nurse Practitioner
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 70203
- Practice address
- 305 E Jefferson St
Boise, ID 83712-6231 - Phone
- (208) 345-0715
- Fax
- (208) 345-1142
- NPI assigned
- Aug 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60583927 | WA | |
| Pediatric Nurse Practitioner | 363LP0200X | 70203 | ID | Primary |
Addresses
Primary practice location
305 E Jefferson St
Boise, ID 83712-6231
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
325 9th Ave
Seattle, WA 98104-2420
Phone (206) 744-1699
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: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60583927 | WA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Pediatrics | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Pediatrics | Current | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
1620 S Celebration Ave
Meridian, ID 83642
Phone (208) 884-1030
9850 W St Lukes Dr
Ste 270
Nampa, ID 83687
Phone (208) 205-7820
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.
-
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
Pediatrics
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1124544192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126231",
"telephone_number": "208-345-0715",
"fax_number": "208-345-1142"
}
],
"practiceLocations": [
{
"address_1": "325 9th Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981042420",
"country_code": "US",
"telephone_number": "206-744-1699",
"fax_number": "206-744-1614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARRIA",
"first_name": "STEPHANIE",
"credential": "BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-21",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60583927",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "ID",
"license": "70203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.