Active NPI
Thor Hauff, FNP-C
- Family Nurse Practitioner
- Boise, ID
National Provider Identifier
1336378124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1160A
- Practice address
- 4971 W Overland Rd
Boise, ID 83705-2822 - Phone
- (208) 472-5050
- Fax
- (208) 472-5051
- NPI assigned
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1160A | ID | Primary |
| Family Nurse Practitioner | 363LF0000X | N-26795 | ID |
Addresses
Primary practice location
4971 W Overland Rd
Boise, ID 83705-2822
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 TX, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201215000716 | TX | Practitioner - Nurse Practitioner | 4183806664 | Reassigns benefits to 1 organization |
| I20230418002040 | ID | Practitioner - Nurse Practitioner | 4183806664 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alliance Medical Group LLC
Practice addresses (Care Compare)
4971 W Overland Rd
Boise, ID 83705-2822
Phone (208) 472-5050
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.87 of 100
- Quality
- 77.29
- Promoting interoperability
- 97
- Improvement activities
- 40
- Cost
- 74.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1160A | ID | MD | Family Nurse Practitioner |
| N-26795 | ID | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Medical Group, LLC | Current | Accepting new patients | |
| Ely Shoshone Tribe | Current | Accepting new patients | |
| Alliance Medical Group, LLC | Current | Accepting new patients | |
| Ely Shoshone Tribe | Past | Accepting new patients | |
| Alliance Medical Group, LLC | Past | Accepting new patients |
Locations
4971 W Overland Rd
Boise, ID 83705
Phone (208) 472-5050
10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690
400 B Newe Vw
Ely, NV 89301
Phone (775) 289-2134
505 S Pioche Hwy
Ely, NV 89301
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1336378124",
"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": "208-955-6503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4971 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837052822",
"telephone_number": "208-472-5050",
"fax_number": "208-472-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUFF",
"first_name": "THOR",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "1160A",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "N-26795",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.