Individual provider Active NPI

David Kalani Mench, PA-C

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1457876815
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2052 Issued in ID
Practice address
3015 E Magic View Dr Ste 115
Meridian, ID 83642-3743
Phone
(208) 321-4000
NPI assigned
Aug 7, 2017
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2052 ID Primary

Addresses

Primary practice location

3015 E Magic View Dr Ste 115
Meridian, ID 83642-3743

Mailing address

7529 W Middle Fork St
Boise, ID 83709-6090
Phone (808) 754-2010

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210902001659 ID Practitioner - Physician Assistant 1759787583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Direct Orthopedic Care LLCGroup PAC ID 2163648155, 32 clinicians

Practice addresses (Care Compare)

3015 E Magic View Dr
Suite 130
Meridian, ID 83642-3750

7979 W Rifleman St
Suite 110
Boise, ID 83704-9066
Phone (208) 321-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2052IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Orthopedic Care LLC CurrentSince Sep 15, 2021 Accepting new patients

Locations

7979 W Rifleman St
Boise, ID 83704
Phone (208) 321-4000

7979 W Rifleman St
Ste 110
Boise, ID 83704
Phone (208) 321-4000

3015 E Magic View Dr
Ste 115
Meridian, ID 83642
Phone (208) 321-4000

3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567

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.

Hospital & facility affiliations 3

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1457876815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7529 W MIDDLE FORK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096090",
            "telephone_number": "808-754-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E MAGIC VIEW DR STE 115",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423743",
            "telephone_number": "208-321-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCH",
        "first_name": "DAVID",
        "middle_name": "KALANI",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.