NPIMap

Individual provider Active NPI

Nicholas Brandi

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1225858475
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6661573 Issued in ID
Practice address
1907 S Broadway Ave Ste 101
Boise, ID 83706-4229
Phone
(208) 345-1222
Fax
(208) 345-1261
NPI assigned
Oct 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6661573 ID Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 6661573 ID

Addresses

Primary practice location

1907 S Broadway Ave Ste 101
Boise, ID 83706-4229

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

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
I20241216001038 ID Practitioner - Nurse Practitioner 0749716686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLC 132 clinicians
Key Stone Health Care 6 clinicians

Practice addresses (Care Compare)

1907 S Broadway Ave
Suite 101
Boise, ID 83706-4229
Phone (208) 345-1222

21 N Fisher Park Way
Eagle, ID 83616-4796
Phone (208) 514-0670

Hospital & facility affiliations

  • First Choice Home Care Home health agency, Boise, ID, CCN 137108
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6661573IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Multi-Specialty Current Accepting new patients
Alliance Medical Group, LLC Multi-Specialty CurrentSince Nov 10, 2025 Accepting new patients
Key Stone Health Care Multi-Specialty CurrentSince Nov 1, 2024 Accepting new patients
Keystone Hospice, LLC CurrentSince Oct 1, 2024 Accepting new patients
Alliance Medical Group, LLC Multi-Specialty Past Accepting new patients

Locations

1907 S Broadway Ave
Ste 101
Boise, ID 83706
Phone (208) 345-1222

21 N Fisher Park Way
Eagle, ID 83616
Phone (208) 514-0670

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

Interoperability endpoints

  • Direct secure messaging: nicholas.brandi@phmg.eclinicaldirectplus.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 6

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1225858475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S BROADWAY AVE STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064229",
            "telephone_number": "208-345-1222",
            "fax_number": "208-345-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDI",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "6661573",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "6661573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.