NPIMap

Individual provider Active NPI

Reynaldo Celestino, FNP

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1407325533
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-60101 Issued in ID
Practice address
701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone
(208) 381-4210
NPI assigned
Nov 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-60101 ID Primary

Addresses

Primary practice location

701 E Parkcenter Blvd
Boise, ID 83706-6528

Mailing address

190 E Bannock St
Boise, ID 83712-6241

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
I20190123004122 ID Practitioner - Nurse Practitioner 3173860525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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
Nnu Health IncGroup PAC ID 3072964238, 4 clinicians

Practice addresses (Care Compare)

701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone (208) 381-6500

823 E Amity Ave
Nampa, ID 83686-5800
Phone (208) 467-8428

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-60101IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nnu Health Inc. Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jan 16, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jan 16, 2023 Accepting new patients
Northwest Nazarene University Health Clinic Family Medicine Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

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

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

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

623 S University Blvd
Nampa, ID 83686
Phone (208) 250-0836

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

823 E Amity Ave
Nampa, ID 83686
Phone (208) 467-8428

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1407325533",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066528",
            "telephone_number": "208-381-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELESTINO",
        "first_name": "REYNALDO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-19",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-60101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.