Active NPI
Richard C Ballantyne, DO
- Surgery Physician
- Nampa, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- O0485
- Practice address
- 215 E Hawaii Ave
Nampa, ID 83686-6011 - Phone
- (208) 364-3000
- NPI assigned
- May 3, 2007
- Last updated
- Jan 28, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IA-3634 | IA | |
| Surgery Physician | 208600000X | IA-3634 | IA | |
| Surgery Physician | 208600000X | O0485 | ID | Primary |
Addresses
Primary practice location
215 E Hawaii Ave
Nampa, ID 83686-6011
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
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
- General Surgery
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 S Eagle Rd
Meridian, ID 83642-6351
520 S Eagle Rd
Meridian, ID 83642-6355
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711
9850 St Lukes Dr
Nampa, ID 83687-7912
9850 W St Luke's Dr
Nampa, ID 83687-7912
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 18 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IA-3634 | IA | MD | Emergency Medicine Physician |
| O0485 | ID | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Emergency Medicine | Current | Accepting new patients |
| Mercy Physician Group Inc. | Surgery | Past | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
Emergency Medicine
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
dba St Lukes Nampa Medical Center
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1174745582",
"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": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E HAWAII AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866011",
"telephone_number": "208-364-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLANTYNE",
"first_name": "RICHARD",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IA",
"license": "IA-3634",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "IA-3634",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ID",
"license": "O0485",
"primary": true
}
],
"identifiers": [],
"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 Jan 28, 2014; 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.