Dallas D Peck, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

M8235 Issued in ID

Practice address

1055 N Curtis Rd
Boise, ID 83706-1309

Phone

(208) 367-2161

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dpeck1563368@direct.trinity-health.org

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.

• Crouse Radiology Associates LLP

  • Diagnostic Radiology Physician
  • Syracuse, NY
  • NPI 1447244587

  ID

  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023

  ID

  Medicare reassignment NPD
• Geisinger-HM Joint Venture LLC

  • Internal Medicine Physician
  • Muncy, PA
  • NPI 1952076119

  Diagnostic Radiology, ID

  Medicare reassignment NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1073075909
  NPD
• Gooding County Hospital District

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1295769537
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1184665473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9649",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074649",
            "telephone_number": "208-472-8100",
            "fax_number": "208-472-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11995 Singletree Ln Ste 500",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553445349",
            "country_code": "US",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "DALLAS",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-02-27",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M8235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806032500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bryan Pease, D.C.
• Kelli M Pease, PA
• Shaylan Pease, PA-C
• Forrest Q Pecha, MS, ATC, LAT, OTC
• Diane Peck-Niznik, OTR/L
• Matthew Anthony Peck, LPC
• Robert T Peck, DMD
• Theresa Michele Pecsek, PMHNP-BC
• Rachael L Pedersen, NP
• Ryan Pedersen, L.AC., D.O.M.

• Diagnostic Radiology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.