Individual provider Active NPI

Joseph Al Lipetzky, PSY. D.

  • Clinical Psychologist
  • Boise, ID
National Provider Identifier
1467440065
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 338 Issued in ID
Practice address
1755 N Westgate Dr Ste 260
Boise, ID 83704-7176
Phone
(208) 373-0790
Fax
(208) 373-0816
NPI assigned
Oct 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 338 ID Primary

Addresses

Primary practice location

1755 N Westgate Dr Ste 260
Boise, ID 83704-7176

Mailing address

1755 N Westgate Dr Ste 260
Boise, ID 83704-7176
Phone (208) 373-0790

Other identifiers 2

IdentifierTypeStateIssuer
00010016100OtherIDREGENCE BLUE SHIELD
N5509OtherIDBLUE CROSS

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110517000589 ID Practitioner - Clinical Psychologist 0840276309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Psychological Associates, PLLCGroup PAC ID 6103801683, 7 clinicians

Practice addresses (Care Compare)

1755 N Westgate Dr
Suite 260
Boise, ID 83704-7176
Phone (208) 373-0790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 338IDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Psychological Associates, PLLC Clinical CurrentSince Jun 1, 2003 Accepting new patients

Locations

1755 N Westgate Dr
Ste 260
Boise, ID 83704
Phone (208) 373-0790

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1467440065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 N WESTGATE DR STE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047176",
            "telephone_number": "208-373-0790",
            "fax_number": "208-373-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N WESTGATE DR STE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047176",
            "telephone_number": "208-373-0790",
            "fax_number": "208-373-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPETZKY",
        "first_name": "JOSEPH",
        "middle_name": "AL",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-09",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY 338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "00010016100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N5509",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.