NPIMap

Individual provider Active NPI

Edward Gerard Detar, MD

  • Surgery Physician
  • Coeur D Alene, ID
National Provider Identifier
1194706465
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M-9855 Issued in ID
Practice address
700 W Ironwood Dr Ste 341
Coeur D Alene, ID 83814-4404
Phone
(208) 625-5200
Fax
(208) 625-5201
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M-9855 ID Primary

Addresses

Primary practice location

700 W Ironwood Dr Ste 341
Coeur D Alene, ID 83814-4404

Mailing address

700 W Ironwood Dr
Suite 304
Coeur D Alene, ID 83814-2656
Phone (208) 625-5200

Other identifiers 4

IdentifierTypeStateIssuer
77068OtherIDBC ID
P00448097OtherIDRR MEDICARE
807836200MedicaidID
1124619MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address edward.detar.p79@direct.kootenai.nextgenshare.com
Direct Messaging Address edetar609825@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080912000184 ID Practitioner - General Surgery 6002805868 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Human Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Clearwater Valley Hospital & Clinics Hospital, Orofino, ID, CCN 131320
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy16
Hernia repair (minimally invasive)25
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux18
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Valley Hospital & Clinics Inc. CurrentSince Nov 9, 2025 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. CurrentSince Dec 1, 2022 Accepting new patients
Kootenai Health, Inc. CurrentSince Nov 1, 2009 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Surgery Associates PLLC Surgery CurrentSince May 1, 2020 Accepting new patients
Kootenai Health, Inc. Surgery CurrentSince May 1, 2020 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. CurrentSince Dec 1, 2022 Accepting new patients
Kootenai Health, Inc. CurrentSince Nov 1, 2009 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Clearwater Valley Hospital & Clinics Inc. Past Accepting new patients

Locations

700 W Ironwood Dr
Ste 341
Coeur D Alene, ID 83814
Phone (208) 625-5200

700 W Ironwood Dr
Ste 304
Coeur D Alene, ID 83814
Phone (208) 667-1588

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

301 Cedar St
Orofino, ID 83544
Phone (208) 476-4555

1300 E Mullan Ave
Ste 1300
Post Falls, ID 83854
Phone (208) 625-5630

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Interoperability endpoints

  • Direct secure messaging: edetar609825@direct.multicare.org

Organizations & group practices 11

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1194706465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "SUITE 304",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-625-5200",
            "fax_number": "208-625-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 341",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144404",
            "telephone_number": "208-625-5200",
            "fax_number": "208-625-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETAR",
        "first_name": "EDWARD",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-9855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC ID",
            "identifier": "77068",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00448097",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807836200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124619",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.detar.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr Ste 341",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edetar609825@direct.multicare.org",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr Ste 341",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.