Active NPI
Dustin K Bowman, PA-C
- Physician Assistant
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA523
- Practice address
- 100 E Idaho St
Boise, ID 83712-6267 - Phone
- (208) 381-2711
- NPI assigned
- Jun 21, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA523 | ID | Primary |
Addresses
Primary practice location
100 E Idaho St
Boise, ID 83712-6267
Mailing address
190 E Bannock St.
Boise, ID 83712
Phone (208) 381-2711
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E Idaho St
Boise, ID 83712-6267
520 S Eagle Rd
Meridian, ID 83642-6351
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9951 W St Lukes Dr
Nampa, ID 83687-7914
Phone (208) 467-6700
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S McCall
- St Luke'S Elmore Medical Center
- St Luke'S Nampa Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA523 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| John E Gamboa MD PLLC | Past | Accepting new patients | |
| Medical Oncology Associates, PS | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223
520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000
Interoperability endpoints
- dbowman30033@direct.slhs.org
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- Radiation Oncology Physician
- Boise, ID
- NPI 1689607897
-
- Radiation Oncology Physician
- Spokane Valley, WA
- NPI 1831524073
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- McCall, ID
- NPI 1235447970
-
- Critical Access Hospital
- Mountain Home, ID
- NPI 1699013565
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1386680239",
"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": "83712",
"telephone_number": "208-381-2711",
"fax_number": "208-381-4675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E IDAHO ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126267",
"telephone_number": "208-381-2711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "DUSTIN",
"middle_name": "K",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.