NPIMap

Individual provider Active NPI

Daniel Richard Marsh, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Boise, ID
National Provider Identifier
1356377535
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
M9452 Issued in ID
Practice address
987 S Allante PL
Boise, ID 83709-1612
Phone
(208) 947-7246
Fax
(208) 297-7772
NPI assigned
Jun 23, 2006
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X M9452 ID Primary

Addresses

Primary practice location

987 S Allante PL
Boise, ID 83709-1612

Mailing address

987 S Allante PL
Boise, ID 83709-1612
Phone (208) 947-7246

Other identifiers 1

IdentifierTypeStateIssuer
1356377535MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061108000295 ID Practitioner - Physical Medicine and RehabilitationPractitioner - Pain ManagementPractitioner - Medical Oncology 2264495423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Exodus Pain ClinicGroup PAC ID 4789979717, 2 clinicians

Practice addresses (Care Compare)

987 S Allante PL
Boise, ID 83709-1612
Phone (208) 947-7246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9452IDMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Pain Clinic CurrentSince May 2, 2016 Accepting new patients
Spine Colorado PC Past Accepting new patients
Gary Gregerson, M.D., P.a. Past Accepting new patients
Richard Radnovich DO PC PastSince Jul 3, 2016 Accepting new patients
Beacon Kalamazoo Inc Past Accepting new patients
Family Eyecare Specialists PLLC Past Accepting new patients
Neurosurgery of Kalamazoo, P.C. Past Accepting new patients

Locations

4850 N Rosepoint Way
Ste 100
Boise, ID 83713
Phone (208) 393-2100

8950 W Emerald St
Ste 168
Boise, ID 83704
Phone (208) 321-1209

987 S Allante Pl
Boise, ID 83709
Phone (208) 947-7246

409 E Elm St
Caldwell, ID 83605
Phone (208) 342-2104

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16938/brand/1/csg/21/fhir/r4
  • FHIR API: https://familyeyes.ef.prod.fhir.ema-api.com/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/FFDJCA/Endpoint/FFDJCA

Organizations & group practices 7

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 8

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1356377535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 S ALLANTE PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091612",
            "telephone_number": "208-947-7246",
            "fax_number": "208-297-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 S ALLANTE PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091612",
            "telephone_number": "208-947-7246",
            "fax_number": "208-297-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "DANIEL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "ID",
            "license": "M9452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356377535",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.