NPIMap

Individual provider Active NPI

David A Wald, MD

  • Physical Medicine & Rehabilitation Physician
  • Boise, ID
National Provider Identifier
1205859535
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M-14009 Issued in ID
Practice address
1055 N Curtis Road
Boise, ID 83706
Phone
(208) 367-4030
Fax
(208) 367-4051
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME 83180 FL
Physical Medicine & Rehabilitation Physician 208100000X M-14009 ID Primary

Addresses

Primary practice location

1055 N Curtis Road
Boise, ID 83706

Mailing address

3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 367-4030

Other identifiers 1

IdentifierTypeStateIssuer
264726500MedicaidFL

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
I20180212001995 ID Practitioner - Physical Medicine and Rehabilitation 7315939972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis
Boise, ID 83706-1309

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

711 N Curtis Rd
Boise, ID 83706-1445
Phone (208) 605-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 83180FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 12, 2018 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 12, 2018 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: dwald1674958@direct.trinity-health.org

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.

Hospital & facility affiliations 8

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1205859535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-367-4030",
            "fax_number": "208-367-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS ROAD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-367-4030",
            "fax_number": "208-367-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALD",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME 83180",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "M-14009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264726500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.