Individual provider Active NPI

Dylan Quintana, MD

  • Family Medicine Physician
  • Caldwell, ID
National Provider Identifier
1437042231
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5271766 Issued in ID
Practice address
315 E Elm St # 201
Caldwell, ID 83605-4857
Phone
(208) 514-2528
Fax
(208) 375-2217
NPI assigned
May 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5271766 ID Primary

Addresses

Primary practice location

315 E Elm St # 201
Caldwell, ID 83605-4857

Mailing address

777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500

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
I20250715003926 ID Order and Referring Only - Family PracticePractitioner - Family Practice 4284149576

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince Jun 3, 2025 Accepting new patients
Full Circle Health, Inc. PastSince Jun 3, 2025 Accepting new patients

Locations

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

315 E Elm St
#201
Caldwell, ID 83605
Phone (208) 514-2528

Interoperability endpoints

  • Direct secure messaging: dquintana605103@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1437042231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E ELM ST # 201",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054857",
            "telephone_number": "208-514-2528",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "DYLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "5271766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.