Individual provider Active NPI

Phyllis Jenn You, MD

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1265693394
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MR-0996 Issued in ID
Practice address
1520 W State St Ste 100
Boise, ID 83702-4084
Phone
(208) 947-7700
Fax
(208) 947-7701
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MR-0996 ID Primary

Addresses

Primary practice location

1520 W State St Ste 100
Boise, ID 83702-4084

Mailing address

1520 W State St Ste 100
Boise, ID 83702-4084
Phone (208) 947-7700

Other practice location 1

500 W Fort St
# 111
Boise, ID 83702-4501
Phone (208) 422-1000

Other identifiers 1

IdentifierTypeStateIssuer
808083200MedicaidID

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
I20110615000452 ID Practitioner - Family Practice 0446437677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

1520 W State St
Suite 100
Boise, ID 83702-4084
Phone (208) 947-7700

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MR-0996IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince May 1, 2017 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince May 1, 2017 Accepting new patients
Planned Parenthood of Greater Washington & North Idaho Family Medicine Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1520 W State St
Ste 100
Boise, ID 83702
Phone (208) 947-7700

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: phyllis.you.1@13077.direct.athenahealth.com

Organizations & group practices 4

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 3

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1265693394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W STATE ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024084",
            "telephone_number": "208-947-7700",
            "fax_number": "208-322-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W STATE ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024084",
            "telephone_number": "208-947-7700",
            "fax_number": "208-947-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Fort St",
            "address_2": "# 111",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837024501",
            "country_code": "US",
            "telephone_number": "208-422-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOU",
        "first_name": "PHYLLIS",
        "middle_name": "JENN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MR-0996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808083200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.