NPIMap

Individual provider Active NPI

Aurelia Nelson, MD

  • General Practice Physician
  • Boise, ID
National Provider Identifier
1376761437
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
M6523 Issued in ID
Practice address
1910 University Dr
Ms 1351
Boise, ID 83725-0002
Phone
(208) 426-1459
Fax
(208) 426-3005
NPI assigned
Apr 23, 2007
Last updated
Aug 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X M6523 ID Primary

Addresses

Primary practice location

1910 University Dr
Ms 1351
Boise, ID 83725-0002

Mailing address

190 E Bannock
Boise, ID 83712-6241
Phone (208) 381-2222

Other identifiers 1

IdentifierTypeStateIssuer
1376761437MedicaidID

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
I20130905000839 ID Practitioner - Family Practice 5496998775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6523IDMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Sep 1, 2013 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Sep 1, 2013 Accepting new patients
Treasure Valley Emergency Physicians Past Accepting new patients
Boise State Health Center PastSince Dec 13, 2020 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
Premier Emergency Physicians of Idaho Medical Group Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

600 N Robbins Rd
Ste 100
Boise, ID 83702
Phone (208) 381-1615

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: anelson18979@direct.slhs.org

Organizations & group practices 6

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 4

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1376761437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222",
            "fax_number": "208-426-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 UNIVERSITY DR",
            "address_2": "MS 1351",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837250002",
            "telephone_number": "208-426-1459",
            "fax_number": "208-426-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AURELIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M6523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376761437",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.