Individual provider Active NPI

Megan Fitzmaurice

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1336523703
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1600A Issued in ID
Practice address
500 W Fort St
Boise, ID 83702-4501
Phone
(208) 422-1000
NPI assigned
Jul 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-1600A ID Primary

Addresses

Primary practice location

500 W Fort St
Boise, ID 83702-4501

Mailing address

291 Alta Vista Dr
McCall, ID 83638-5102

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170330002197 ID Practitioner - Nurse Practitioner 1052696226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic - McCall LLCGroup PAC ID 7618127994, 44 clinicians

Practice addresses (Care Compare)

211 Forest St
McCall, ID 83638-5256
Phone (208) 634-2225

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic - McCall LLC CurrentSince Mar 20, 2017 Accepting new patients
St Lukes McCall, LTD Past Accepting new patients

Locations

200 W Forest St
McCall, ID 83638
Phone (208) 630-2470

211 W Forest St
McCall, ID 83638
Phone (208) 467-7546

Organizations & group practices 2

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 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": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1336523703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 ALTA VISTA DR",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZMAURICE",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1600A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.