Active NPI
Adebayo O. Crownson, MD
- Family Medicine Physician
- Nampa, ID
National Provider Identifier
1376589689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M8698
- Practice address
- 85 S Middleton Rd
Nampa, ID 83651 - Phone
- (208) 505-2800
- Fax
- (208) 505-2801
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M8698 | ID | Primary |
Addresses
Primary practice location
85 S Middleton Rd
Nampa, ID 83651
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8752
Other practice location 1
875 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 468-5910
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806439300 | Medicaid | ID |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | adebayo.crownson@sal.eclinicaldirectplus.com | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051031000143 | ID | Practitioner - Family Practice | 6002833985 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1906 Fairview Ave
Caldwell, ID 83605-5425
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
- Multicare Home Health Services, Inc
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8698 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Family Medicine | Past | Accepting new patients |
| Mercy Physician Group Inc. | Past | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
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.
-
- Adult Medicine Physician
- Nampa, ID
- NPI 1104972983
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Family Medicine
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Meridian, ID
- NPI 1831182278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1376589689",
"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": "208-381-8752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 S MIDDLETON RD",
"city": "NAMPA",
"state": "ID",
"postal_code": "83651",
"telephone_number": "208-505-2800",
"fax_number": "208-505-2801"
}
],
"practiceLocations": [
{
"address_1": "875 S Vanguard Way",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "ID",
"postal_code": "836427552",
"country_code": "US",
"telephone_number": "208-468-5910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROWNSON",
"first_name": "ADEBAYO",
"middle_name": "O.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2023-09-12",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M8698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806439300",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "adebayo.crownson@sal.eclinicaldirectplus.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "875 S Vanguard Way",
"city": "Meridian",
"state": "ID",
"country_code": "US",
"postal_code": "836427552",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.