Active NPI
Raquel Croitoru, M.D.
- Gastroenterology Physician
- Nampa, ID
National Provider Identifier
1164525853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- M-5744
- Practice address
- 222 W Iowa Ave Ste a
Nampa, ID 83686-6814 - Phone
- (208) 467-3432
- Fax
- (208) 467-4147
- NPI assigned
- Sep 7, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | M-5744 | ID | Primary |
Addresses
Primary practice location
222 W Iowa Ave Ste a
Nampa, ID 83686-6814
Mailing address
222 W Iowa Ave Ste a
Nampa, ID 83686-6814
Phone (208) 467-3432
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 820451495 | Other | ID | TAX I.D. NUMBER |
| 000010004790 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 002701100 | Medicaid | ID | |
| 57448 | Other | ID | BLUE CROSS OF IDAHO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-5744 | ID | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Arts Day Surgery LLC | Gastroenterology | Current | Accepting new patients |
Locations
222 W Iowa Ave
Ste A
Nampa, ID 83686
Phone (208) 377-4000
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360022400000",
"number": "1164525853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 W IOWA AVE STE A",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866814",
"telephone_number": "208-467-3432",
"fax_number": "208-467-4147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W IOWA AVE STE A",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866814",
"telephone_number": "208-467-3432",
"fax_number": "208-467-4147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROITORU",
"first_name": "RAQUEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2013-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "ID",
"license": "M-5744",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX I.D. NUMBER",
"identifier": "820451495",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010004790",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002701100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "57448",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.