NPIMap

Individual provider Active NPI

Abhilash Desai

  • Psychiatry Physician
  • Boise, ID
National Provider Identifier
1366519084
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M-12079 Issued in ID
Practice address
413 N Allumbaugh St Ste 101
Boise, ID 83704-9219
Phone
(208) 323-1125
Fax
(208) 323-9604
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M-12079 ID Primary

Addresses

Primary practice location

413 N Allumbaugh St Ste 101
Boise, ID 83704-9219

Mailing address

413 N Allumbaugh St
Ste 101
Boise, ID 83704-9219
Phone (617) 922-4957

Other identifiers 1

IdentifierTypeStateIssuer
1366519084MedicaidID

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
I20131105000805 ID Practitioner - Psychiatry 4789644824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

5966 W Curtisian Ave
Boise, ID 83704-8801
Phone (208) 302-5455

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2013 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Horizon Mental Health Management LLC Psychiatry Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

5966 W Curtisian Ave
Boise, ID 83704
Phone (208) 302-5450

413 N Allumbaugh St
Ste 101
Boise, ID 83704
Phone (208) 323-1125

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

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 5

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1366519084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "617-922-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049219",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "ABHILASH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-12079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366519084",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.