Individual provider Active NPI

Walter Bruce Cherny, MD

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1275575839
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M8385 Issued in ID
Practice address
100 E Idaho St
Suite 202
Boise, ID 83712-6267
Phone
(208) 381-7360
Fax
(208) 381-7361
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X M8385 ID Primary

Addresses

Primary practice location

100 E Idaho St
Suite 202
Boise, ID 83712-6267

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-7360

Other names 1

  • W. Bruce Cherny Professional name

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
I20040713000638 ID Practitioner - NeurosurgeryPractitioner - Pediatric Medicine 6709864945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8385IDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 1, 2012 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 1, 2012 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
Pediatric Neurosurgry of Idaho PC Neurological Surgery PastSince Apr 1, 2006 Accepting new patients

Locations

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

300 E Jefferson St
Ste 300
Boise, ID 83712
Phone (208) 381-4100

100 E Idaho St
Ste 202
Boise, ID 83712
Phone (208) 381-7360

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

Interoperability endpoints

  • Direct secure messaging: bcherny17542@direct.slhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1275575839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-7360",
            "fax_number": "208-381-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "address_2": "SUITE 202",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126267",
            "telephone_number": "208-381-7360",
            "fax_number": "208-381-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNY",
        "first_name": "WALTER",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M8385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W. BRUCE",
            "last_name": "CHERNY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.