Individual provider Active NPI

Brian Allen Walker, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Boise, ID
National Provider Identifier
1417453382
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
036.162725 Issued in IL
Practice address
900 N Liberty St Ste 400
Boise, ID 83704-8707
Phone
(208) 336-4368
NPI assigned
Mar 31, 2018
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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
Otolaryngology Physician 207Y00000X R76750 AZ
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 036.162725 IL Primary

Addresses

Primary practice location

900 N Liberty St Ste 400
Boise, ID 83704-8707

Mailing address

900 N Liberty St Ste 400
Boise, ID 83704-8707
Phone (208) 336-4368

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259
Phone (480) 301-8000

Other practice location 2

1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone (883) 527-8748

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwalker390333@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230627001377 IL Practitioner - Otolaryngology 3476801952 Reassigns benefits to 1 organization
I20240709002193 ID Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 3476801952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Washington School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

900 N Liberty St
Suite 400
Boise, ID 83704-8707
Phone (208) 336-4368

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.94 of 100Reported as group
Quality
63.68
Improvement activities
40
Cost
68.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.162725ILMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Otolaryngology CurrentSince Jul 1, 2023 Accepting new patients
Southwest Idaho Ear, Nose and Throat Otolaryngology CurrentSince Jul 1, 2024 Accepting new patients

Locations

900 N Liberty St
Boise, ID 83704
Phone (208) 367-2229

900 N Liberty St
Ste 400
Boise, ID 83704
Phone (208) 336-4368

1611 W Harrison St
Ste 550
Chicago, IL 60612
Phone (312) 563-4431

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: bwalker390333@ehrdirect.mayoclinicmsg.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAGCD

Organizations & group practices 2

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 7

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": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1417453382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-336-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-336-4368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "85259",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 W Harrison St Ste 550",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124861",
            "country_code": "US",
            "telephone_number": "883-527-8748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRIAN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-31",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "R76750",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": "036.162725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwalker390333@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "85259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.