NPIMap

Individual provider Active NPI

Tim R Loewenstein, PA

  • Medical Physician Assistant
  • Meridian, ID
National Provider Identifier
1376597377
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA349 Issued in ID
Practice address
3280 E Lanark Dr
Meridian, ID 83642-5982
Phone
(208) 895-8670
Fax
(208) 955-0494
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA349 ID Primary

Addresses

Primary practice location

3280 E Lanark Dr
Meridian, ID 83642-5982

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Other identifiers 1

IdentifierTypeStateIssuer
806033700MedicaidID

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
I20050524000150 ID Practitioner - Physician Assistant 8123060837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

10482 W Carlton Bay Dr
Garden City, ID 83714-5143
Phone (208) 955-6500

1474 N Meridian Rd
Kuna, ID 83634-2041
Phone (208) 809-2885

1475 N Cole Rd
Boise, ID 83704-8537
Phone (208) 809-2880

1623 S Wells Ave
Meridian, ID 83642-5040
Phone (208) 489-1450

1895 McGrath Rd
Eagle, ID 83616-6243
Phone (208) 939-8200

1900 W Chinden Blvd
Meridian, ID 83646-6690
Phone (208) 809-2860

260 S Ten Mile Rd
Meridian, ID 83642-6100
Phone (208) 809-2872

4971 W Overland Rd
Boise, ID 83705-2822
Phone (208) 472-5050

512 N 21St Ave
Caldwell, ID 83605-4368
Phone (208) 809-2875

8971 W Overland Rd
Boise, ID 83709-1651
Phone (208) 378-4288

Hospital & facility affiliations

  • Bluebird Home Health Home health agency, Meridian, ID, CCN 137049
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA349IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Current Accepting new patients
Alliance Medical Group, LLC CurrentSince Jun 1, 2005 Accepting new patients
Alliance Medical Group, LLC Past Accepting new patients

Locations

801 N Stilson Rd
Boise, ID 83703
Phone (208) 343-3652

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

3280 E Lanark Dr
Meridian, ID 83642
Phone (208) 377-4400

Interoperability endpoints

  • Direct secure messaging: timothy.loewenstein@phmg.eclinicaldirectplus.com

Organizations & group practices 20

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.

View all 20

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1376597377",
    "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": "3280 E LANARK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425982",
            "telephone_number": "208-895-8670",
            "fax_number": "208-955-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEWENSTEIN",
        "first_name": "TIM",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806033700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.