Active NPI
Allison Brooke Bastian, MD
- Family Medicine Physician
- Boise, ID
National Provider Identifier
1164862058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M-12732
- Practice address
- 777 N Raymond St
Boise, ID 83704-9251 - Phone
- (208) 514-2500
- Fax
- (208) 375-2217
- NPI assigned
- Jun 25, 2013
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MRM-1333 | ID | |
| Family Medicine Physician | 207Q00000X | M-12732 | ID | Primary |
Addresses
Primary practice location
777 N Raymond St
Boise, ID 83704-9251
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164862058 | Medicaid | ID |
Other names 1
- Allison Brooke Owens
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MRM-1333 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
6565 W Emerald St
Boise, ID 83704
Phone (208) 377-5055
325 W Idaho St
Boise, ID 83702
Phone (208) 514-2525
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
2275 S Eagle Rd
Ste 120
Meridian, ID 83642
Phone (208) 514-2520
Interoperability endpoints
- abastian294815@direct.ochin.org
- allisonb@yourcarecommunity.org
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.
-
- Federally Qualified Health Center (FQHC)
- Boise, ID
- NPI 1841490075
-
- 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.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
-
- 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": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1164862058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIAN",
"first_name": "ALLISON",
"middle_name": "BROOKE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "MRM-1333",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M-12732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1164862058",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALLISON",
"last_name": "OWENS",
"middle_name": "BROOKE",
"code": "1",
"type": "Former Name"
}
]
}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 Jan 25, 2017; 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.