Active NPI
Benjamin Prinzing
- Family Nurse Practitioner
- Eagle, ID
National Provider Identifier
1437661345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 57136
- Practice address
- 951 E Plaza Dr Ste 110
Eagle, ID 83616-6567 - Phone
- (208) 938-5680
- NPI assigned
- Nov 1, 2017
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 57136 | ID | Primary |
Addresses
Primary practice location
951 E Plaza Dr Ste 110
Eagle, ID 83616-6567
Mailing address
3725 S Coldstream Ave
Boise, ID 83709-4821
Phone (208) 859-0907
Other practice location 1
3725 S Coldstream Ave
Boise, ID 83709-4821
Phone (208) 859-0907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Previously, effective Oct 1, 2022 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peine Osteopathic Medicine PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Eagle, ID
- NPI 1306010046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1437661345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 S COLDSTREAM AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837094821",
"telephone_number": "208-859-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 E PLAZA DR STE 110",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166567",
"telephone_number": "208-938-5680"
}
],
"practiceLocations": [
{
"address_1": "3725 S Coldstream Ave",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837094821",
"country_code": "US",
"telephone_number": "208-859-0907",
"fax_number": "208-859-0907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRINZING",
"first_name": "BENJAMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-01",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "57136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.