NPIMap

Individual provider Active NPI

Kahdi F Udobi, MD

  • Surgical Critical Care Physician
  • Boise, ID
National Provider Identifier
1205935624
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
MC-2857 Issued in ID
Practice address
999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone
(208) 302-2600
Fax
(208) 302-2625
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 04-28402 KS
Surgical Critical Care Physician 2086S0102X 078646 GA
Surgical Critical Care Physician 2086S0102X MC-2857 ID Primary

Addresses

Primary practice location

999 N Curtis Rd Ste 415
Boise, ID 83706-1334

Mailing address

PO Box 190930
Boise, ID 83719-0930

Other practice location 1

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1415

Other identifiers 4

IdentifierTypeStateIssuer
204755102MedicaidMO
25911010OtherMOBCBS KANSAS CITY
100345850AMedicaidKS
372600OtherKSFIRSTGUARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180524002960 GA Practitioner - General Surgery 8921131897 Reassigns benefits to 2 organizations
I20240609000180 ID Practitioner - Critical Care (Intensivists) 8921131897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

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

3025 W Cherry LN
Meridian, ID 83642-8531

999 N Curtis Rd
Suite 415
Boise, ID 83706-1334
Phone (208) 302-2600

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St. Alphonsus Medical Center - Baker City Hospital, Baker City, OR, CCN 381315
  • Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-28402KSMDSurgery Physician
078646GAMDSurgical Critical Care Physician
MC-2857IDMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Jan 1, 2025 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Morehouse Healthcare, Inc. Surgery CurrentSince Oct 28, 2017 Accepting new patients
Saint Alphonsus Specialty Services Inc Surgery PastSince Jun 2, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

720 Westview Dr SW
Atlanta, GA 30310
Phone (404) 756-1383

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

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

999 N Curtis Rd
Ste 415
Boise, ID 83706
Phone (208) 302-2600

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: kudobi3402393@direct.trinity-health.org

Organizations & group practices 6

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1205935624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N CURTIS RD STE 415",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061334",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033031",
            "country_code": "US",
            "telephone_number": "404-616-1415",
            "fax_number": "404-616-1417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDOBI",
        "first_name": "KAHDI",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-28402",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "078646",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "MC-2857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204755102",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "25911010",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100345850A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "372600",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.