Individual provider Active NPI

Barry Jon Shinsel

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1144930801
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
74512 Issued in ID
Practice address
425 W Bannock St
Boise, ID 83702-6035
Phone
(208) 343-6458
NPI assigned
Dec 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 74512 ID Primary

Addresses

Primary practice location

425 W Bannock St
Boise, ID 83702-6035

Mailing address

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 343-6458

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110002037 ID Practitioner - Nurse Practitioner 3577933423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Gastroenterology Associates LLPGroup PAC ID 6002708773, 35 clinicians

Practice addresses (Care Compare)

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 489-1431

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Gastroenterology Associates, LLP CurrentSince Dec 6, 2022 Accepting new patients
Southern Idaho Health Partners LLC Past Accepting new patients

Locations

425 W Bannock St
Boise, ID 83702
Phone (208) 343-1702

875 S Vanguard Way
Ste 310
Meridian, ID 83642
Phone (208) 343-6458

2235 E Gala St
Meridian, ID 83642
Phone (208) 489-1431

1200 Garrity Blvd
Nampa, ID 83687
Phone (208) 343-6458

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 2

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": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1144930801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026035",
            "telephone_number": "208-343-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026035",
            "telephone_number": "208-343-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINSEL",
        "first_name": "BARRY",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "74512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.