Individual provider Active NPI

Spencer Raye Paulson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Boise, ID
National Provider Identifier
1215290275
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
R73285 Issued in AZ
Practice address
6259 W Emerald St
Boise, ID 83704-8731
Phone
(208) 489-1900
NPI assigned
Jun 24, 2012
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R73285 AZ Primary

Addresses

Primary practice location

6259 W Emerald St
Boise, ID 83704-8731

Mailing address

3614 E Newby St
Nampa, ID 83687-9201
Phone (208) 205-1000

Other identifiers 1

IdentifierTypeStateIssuer
R73285OtherAZARIZONA TRAINING LICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240806002886 ID Practitioner - Pathology 6709323918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Pathology Services IncGroup PAC ID 2567406689, 5 clinicians
Digestive Health Clinic LLCGroup PAC ID 7315948874, 26 clinicians

Practice addresses (Care Compare)

1717 Arlington Ave
Caldwell, ID 83605-4802
Phone (208) 459-4641

6259 W Emerald St
Boise, ID 83704-8731
Phone (208) 489-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73285AZMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Services Inc Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2024 Accepting new patients
Digestive Health Clinic LLC Current Accepting new patients
Idaho Endoscopy Center LLC Current Accepting new patients
Digestive Health Clinic LLC CurrentSince Aug 27, 2024 Accepting new patients
West Valley Professional Fee Billing, LLC Current Accepting new patients

Locations

6259 W Emerald St
Boise, ID 83704
Phone (208) 489-1900

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

5080 E Commerce St
Nampa, ID 83687
Phone (208) 489-1900

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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 1

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": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1215290275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 E NEWBY ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836879201",
            "telephone_number": "208-205-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048731",
            "telephone_number": "208-489-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "SPENCER",
        "middle_name": "RAYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R73285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA TRAINING LICENSE NUMBER",
            "identifier": "R73285",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.