Individual provider Active NPI

Michael Joseph Suida, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1407802127
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA559 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1352
Phone
(208) 367-6416
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X N32502 ID
Certified Registered Nurse Anesthetist 367500000X RNA559 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1352

Mailing address

PO Box 4268
Portland, OR 97208-4268
Phone (503) 372-2740

Other identifiers 1

IdentifierTypeStateIssuer
806738300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318001215 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648160069 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

Hospital & facility affiliations

  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N32502IDMDRegistered Nurse
RNA559IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants of Treasure Valley PLLC CurrentSince Oct 1, 2019 Accepting new patients
Boise Anesthesia, P a Nurse Anesthetist, Certified Registered CurrentSince Oct 6, 2003 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 6, 2024 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 6, 2024 Accepting new patients
Boise Anesthesia, PA Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

8800 W Emerald St
Boise, ID 83704
Phone (208) 373-5000

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 1

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1407802127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4268",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084268",
            "telephone_number": "503-372-2740",
            "fax_number": "503-372-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061352",
            "telephone_number": "208-367-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUIDA",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N32502",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806738300",
            "state": "ID"
        }
    ],
    "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 Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.