NPIMap

Organization Active NPI

Treasure Valley Gastroenterology Specialists Inc

  • Gastroenterology Physician
  • Nampa, ID
National Provider Identifier
1194817023
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M-5744 Issued in ID
Legal business name
TREASURE VALLEY GASTROENTEROLOGY SPECIALISTS INC
Practice address
222 W Iowa Ave
Suite a
Nampa, ID 83686-6813
Phone
(208) 467-3432
Fax
(208) 467-4147
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Raquel Croitoru, M.D.
Title
Gastroenterologist
Phone
(208) 467-3432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X M-5744 ID Primary

Addresses

Primary practice location

222 W Iowa Ave
Suite a
Nampa, ID 83686-6813

Mailing address

222 W Iowa Ave
Suite a
Nampa, ID 83686-6813
Phone (208) 467-3432

Other identifiers 3

IdentifierTypeStateIssuer
002701100MedicaidID
000010006187OtherIDREGENCE BLUE SHIELD OF ID
84160OtherIDBLUE CROSS OF IDAHO

National Provider Directory

National Provider Directory

Locations

222 W Iowa Ave
Ste A
Nampa, ID 83686
Phone (208) 377-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1194817023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W IOWA AVE",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866813",
            "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",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866813",
            "telephone_number": "208-467-3432",
            "fax_number": "208-467-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY GASTROENTEROLOGY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "CROITORU",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "GASTROENTEROLOGIST",
        "authorized_official_telephone_number": "208-467-3432",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M-5744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002701100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010006187",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "84160",
            "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 4, 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.

Verify at the official NPI Registry.