NPIMap

Individual provider Active NPI

Ondrej Choutka, MD

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1265651566
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M-13330 Issued in ID
Practice address
1072 N Liberty Street
Ste 303
Boise, ID 83704
Phone
(208) 367-4035
Fax
(208) 367-7111
NPI assigned
Apr 25, 2007
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 57009091 OH
Neurological Surgery Physician 207T00000X 43915 KY
Neurological Surgery Physician 207T00000X M-13330 ID Primary

Addresses

Primary practice location

1072 N Liberty Street
Ste 303
Boise, ID 83704

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-4035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, 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
I20110804000582 KY Practitioner - Neurosurgery 4688843824 Reassigns benefits to 1 organization
I20160722000926 ID Practitioner - Neurosurgery 4688843824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2002
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

1072 N Liberty St
Boise, ID 83704-8708

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion16
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-13330IDMDNeurological Surgery Physician
43915KYMDNeurological Surgery Physician
57009091OHMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc CurrentSince Jul 19, 2011 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Neurological Surgery Current Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients

Locations

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

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

617 23rd St
Ste 400
Ashland, KY 41101
Phone (606) 329-1770

Interoperability endpoints

  • Direct secure messaging: ochoutka1564273@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 10

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1265651566",
    "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": "836421026",
            "telephone_number": "208-367-4035",
            "fax_number": "208-367-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY STREET",
            "address_2": "STE 303",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-367-4035",
            "fax_number": "208-367-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUTKA",
        "first_name": "ONDREJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "57009091",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "KY",
            "license": "43915",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M-13330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.