Active NPI
Eric Robert Smith, M.D.
- Neuroradiology Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- M-17109
- Practice address
- 333 N 1St St Ste 250
Boise, ID 83702-6132 - Phone
- (208) 381-9384
- NPI assigned
- Jul 7, 2015
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | A167502 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | 67899-20 | WI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301107050 | MI | |
| Neuroradiology Physician | 2085N0700X | M-17109 | ID | Primary |
Addresses
Primary practice location
333 N 1St St Ste 250
Boise, ID 83702-6132
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866
Other practice location 1
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-1195
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Indiana University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384
333 N 1St St
Boise, ID 83702-6132
520 S Eagle Rd
Meridian, ID 83642-6351
520 S Eagle Rd
Meridian, ID 83642-6363
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
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
- St Lukes Magic Valley Medical Center
- St Luke'S Elmore Medical Center
- St Luke'S Wood River Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A167502 | CA | MD | Neuroradiology Physician |
| M-17109 | ID | MD | Neuroradiology Physician |
| 67899-20 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | 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
333 N 1st St
Ste 250
Boise, ID 83702
Phone (208) 381-9384
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mountain Home, ID
- NPI 1699013565
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
-
- Critical Access Hospital
- Ketchum, ID
- NPI 1508869470
-
- General Acute Care Hospital
- Twin Falls, ID
- NPI 1932154705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1447633532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-8866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N 1ST ST STE 250",
"city": "BOISE",
"state": "ID",
"postal_code": "837026132",
"telephone_number": "208-381-9384"
}
],
"practiceLocations": [
{
"address_1": "9200 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-955-1195",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "ERIC",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "A167502",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "67899-20",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301107050",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "ID",
"license": "M-17109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.