Individual provider Active NPI

Kyrsten E Stoops, MD

  • Family Medicine Physician
  • Moscow, ID
National Provider Identifier
1417261934
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.60298970 Issued in WA
Practice address
623 S Main St Ste 1
Moscow, ID 83843
Phone
(208) 882-2011
Fax
(208) 883-1853
NPI assigned
Jul 27, 2010
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X M-12207 ID
Family Medicine Physician 207Q00000X MD.60298970 WA Primary

Addresses

Primary practice location

623 S Main St Ste 1
Moscow, ID 83843

Mailing address

PO Box 8007
Moscow, ID 83843-0507
Phone (208) 883-2224

Other practice location 1

2500 W A St Ste 101
Moscow, ID 83843-6000
Phone (208) 882-0540

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131219001667 ID Practitioner - Family Practice 7810137098 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gritman Medical Center IncGroup PAC ID 0941545784, 27 clinicians

Practice addresses (Care Compare)

623 S Main St
Suite 1
Moscow, ID 83843-2983
Phone (208) 882-2011

700 S Main St
Moscow, ID 83843-3056
Phone (208) 883-6236

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.60298970WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gritman Medical Center, Inc. Family Medicine CurrentSince Sep 15, 2022 Accepting new patients
Gritman Medical Center, Inc. Family Medicine CurrentSince Sep 15, 2022 Accepting new patients
Gritman Medical Center Inc CurrentSince Sep 15, 2022 Accepting new patients
Gritman Medical Center Inc. CurrentSince Sep 15, 2022 Accepting new patients

Locations

2500 W A St
Ste 101
Moscow, ID 83843
Phone (208) 882-0540

623 S Main St
Ste 1
Moscow, ID 83843
Phone (208) 882-2011

700 S Main St
Moscow, ID 83843
Phone (208) 746-7555

Interoperability endpoints

  • Direct secure messaging: kstoops689755@direct.ochin.org

Organizations & group practices 4

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 2

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1417261934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8007",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838430507",
            "telephone_number": "208-883-2224",
            "fax_number": "208-883-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S MAIN ST STE 1",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W A St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838436000",
            "country_code": "US",
            "telephone_number": "208-882-0540",
            "fax_number": "208-883-1853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOOPS",
        "first_name": "KYRSTEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-12207",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.60298970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.