NPIMap

Individual provider Active NPI

Mary O'Kief Dittrich, MD

  • Nephrology Physician
  • Meridian, ID
National Provider Identifier
1437194552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
M7706 Issued in ID
Practice address
3525 E Louise Dr
Ste 100
Meridian, ID 83642-6302
Phone
(208) 846-8335
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X M7706 ID Primary

Addresses

Primary practice location

3525 E Louise Dr
Ste 100
Meridian, ID 83642-6302

Mailing address

2702 Holden LN
Boise, ID 83706-5060

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
I20051129000038 ID Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Endocrinology 4789674219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Colorado School of Medicine, Denver, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

290 W Georgia Ave
Nampa, ID 83686-2835
Phone (208) 385-3670

4620 Enterprise Way
Suite 101
Caldwell, ID 83605-6764
Phone (208) 846-8335

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7706IDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Usrc South Arlington, LLC PastSince Feb 14, 2020 Accepting new patients
Usrc Sharpstown LLC PastSince Apr 16, 2021 Accepting new patients
Usrc Stephenville LLC PastSince Feb 12, 2020 Accepting new patients
Rocky Mountain Kidney Care Professional Service Corp Nephrology PastSince Dec 16, 2024 Accepting new patients
Usrc Fall Creek, LLC PastSince Feb 16, 2023 Accepting new patients
Calah Partners, LLC PastSince Aug 13, 2020 Accepting new patients
Snowy Range Kidney Care LLC Nephrology PastSince Sep 1, 2020 Accepting new patients
Mvny Partners VII, LLC PastSince Apr 16, 2021 Accepting new patients
Usrc Aloha LLC PastSince Mar 31, 2021 Accepting new patients
Usrc Mesa, LLC PastSince Sep 1, 2022 Accepting new patients
William Restrepo MD PA Nephrology PastSince Aug 1, 2022 Accepting new patients
Satellite Dialysis of Central Merced LLC PastSince Jun 19, 2023 Accepting new patients
Rocky Mountain Kidney Care LLC Nephrology PastSince May 5, 2020 Accepting new patients
Usrc Hamburg LLC PastSince Mar 18, 2021 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

3525 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 999-0356

3525 E Louise Dr
Ste 195
Meridian, ID 83642

Interoperability endpoints

  • Direct secure messaging: mdittrich37831@direct.slhs.org
  • FHIR API: https://api.platform.athenahealth.com/19427/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22460/brand/1/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437194552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 HOLDEN LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR",
            "address_2": "STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426302",
            "telephone_number": "208-846-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "MARY",
        "middle_name": "O'KIEF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "M7706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.