Active NPI
Olga M. Fortenko, M.D.
- Pulmonary Disease Physician
- Meridian, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- M-17729
- Practice address
- 2347 E Gala St
Meridian, ID 83642-4881 - Phone
- (208) 323-3767
- Fax
- (208) 323-3768
- NPI assigned
- Apr 28, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | A110003 | CA | |
| Pulmonary Disease Physician | 207RP1001X | A110003 | CA | |
| Pulmonary Disease Physician | 207RP1001X | M-17729 | ID | Primary |
Addresses
Primary practice location
2347 E Gala St
Meridian, ID 83642-4881
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8752
Other practice location 1
2950 Whipple Ave Ste 4
Redwood City, CA 94062-2842
Phone (650) 216-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Saint Louis University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384
2347 E Gala St
Meridian, ID 83642-4881
Phone (208) 323-3767
520 S Eagle Rd
Meridian, ID 83642-6351
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
- St Luke'S Elmore Medical Center
- St Luke'S McCall
- St Lukes Magic Valley Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.71 of 100
- Quality
- 90.53
- Promoting interoperability
- 94
- Improvement activities
- 40
- Cost
- 66.16
Merit-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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A110003 | CA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mojdeh Talebian, M.D., Inc. | Pulmonary Disease | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
2950 Whipple Ave
Ste 4
Redwood City, CA 94062
Phone (650) 216-9000
2051 E Summersweet Dr
Boise, ID 83716
Phone (208) 323-3767
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
2347 E Gala St
Meridian, ID 83642
Phone (208) 323-0031
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EDJABA
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- Pulmonary Disease Physician
- Redwood City, CA
- NPI 1578699112
-
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- McCall, ID
- NPI 1235447970
-
- Critical Access Hospital
- Mountain Home, ID
- NPI 1699013565
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
-
- General Acute Care Hospital
- Twin Falls, ID
- NPI 1932154705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1154596336",
"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",
"telephone_number": "208-381-8752",
"fax_number": "650-365-1157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2347 E GALA ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836424881",
"telephone_number": "208-323-3767",
"fax_number": "208-323-3768"
}
],
"practiceLocations": [
{
"address_1": "2950 Whipple Ave Ste 4",
"address_purpose": "LOCATION",
"city": "Redwood City",
"state": "CA",
"postal_code": "940622842",
"country_code": "US",
"telephone_number": "650-216-9000",
"fax_number": "650-365-1157",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTENKO",
"first_name": "OLGA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CA",
"license": "A110003",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "A110003",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "ID",
"license": "M-17729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.