Individual provider Active NPI

Brian D Affleck, MD

  • Otolaryngology Physician
  • Nampa, ID
National Provider Identifier
1386633824
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
M-6075 Issued in ID
Practice address
215 E Hawaii Ave
Saltzer Medical Group
Nampa, ID 83686-6011
Phone
(208) 463-3000
Fax
(208) 465-4825
NPI assigned
Oct 18, 2005
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD154152 OR
Otolaryngology Physician 207Y00000X 5874 AK
Otolaryngology Physician 207Y00000X M-6075 ID Primary

Addresses

Primary practice location

215 E Hawaii Ave
Saltzer Medical Group
Nampa, ID 83686-6011

Mailing address

215 E Hawaii Ave
Saltzer Medical Group
Nampa, ID 83686-6011
Phone (208) 463-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.affleck@sal.eclinicaldirectplus.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215002555 WY Practitioner - Otolaryngology 4183715436 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Lincoln County Hospital District CurrentSince Jan 1, 2023 Accepting new patients
North Lincoln County Hospital District CurrentSince Jan 1, 2023 Accepting new patients
Mat-Su Ear, Nose, Throat & Facial Plastics, Inc. Otolaryngology PastSince Nov 11, 2005 Accepting new patients

Locations

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1386633824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "address_2": "SALTZER MEDICAL GROUP",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-465-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "address_2": "SALTZER MEDICAL GROUP",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-465-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFFLECK",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD154152",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AK",
            "license": "5874",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ID",
            "license": "M-6075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.affleck@sal.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "215 E Hawaii Ave",
            "address_2": "Saltzer Medical Group",
            "city": "Nampa",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836866011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.