NPIMap

Individual provider Active NPI

Sean Craig Stout, MD

  • Allergy & Immunology Physician
  • Boise, ID
National Provider Identifier
1417488131
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
M-16211 Issued in ID
Practice address
901 N Curtis Rd Ste 100
Boise, ID 83706-1339
Phone
(208) 378-0080
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2017021058 MO
Allergy & Immunology Physician 207K00000X 2020009905 MO
Student in an Organized Health Care Education/Training Program 390200000X
Allergy & Immunology Physician 207K00000X M-16211 ID Primary

Addresses

Primary practice location

901 N Curtis Rd Ste 100
Boise, ID 83706-1339

Mailing address

901 N Curtis Rd Ste 100
Boise, ID 83706-1339
Phone (208) 378-0080

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
I20220526001632 ID Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 8628349669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
University of Texas Medical Branch at Galveston, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boise Valley Asthma and Allergy PAGroup PAC ID 6901860014, 7 clinicians

Practice addresses (Care Compare)

901 N Curtis Rd
Suite 100
Boise, ID 83706-1339
Phone (208) 378-0080

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16211IDMDAllergy & Immunology Physician
2020009905MOMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Valley Asthma & Allergy PA Allergy & Immunology CurrentSince Feb 18, 2022 Accepting new patients
Gem State Neurology PLLC PastSince Jun 23, 2025 Accepting new patients
Boise Kidney & Hypertension PLLC PastSince Feb 18, 2022 Accepting new patients

Locations

901 N Curtis Rd
Ste 100
Boise, ID 83706
Phone (208) 378-0080

1825 S Kimball Ave
Caldwell, ID 83605
Phone (208) 454-0567

323 E Riverside Dr
Ste 204
Eagle, ID 83616
Phone (208) 378-0080

2320 E Gala St
Ste 500
Meridian, ID 83642
Phone (208) 378-0080

16060 Idaho Center Blvd
Nampa, ID 83687
Phone (208) 278-6338

4424 E Flamingo Ave
Ste 340
Nampa, ID 83687
Phone (208) 378-0080

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.

Hospital & facility affiliations 9

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1417488131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061339",
            "telephone_number": "208-378-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061339",
            "telephone_number": "208-378-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "SEAN",
        "middle_name": "CRAIG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2017021058",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MO",
            "license": "2020009905",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "ID",
            "license": "M-16211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.