Individual provider Active NPI

Kurt J Nilsson, MD

  • Sports Medicine (Family Medicine) Physician
  • Boise, ID
National Provider Identifier
1477581122
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
M8827 Issued in ID
Practice address
1109 W Myrtle St
Suite 200
Boise, ID 83702-6970
Phone
(208) 383-0201
Fax
(208) 489-4300
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X M8827 ID Primary

Addresses

Primary practice location

1109 W Myrtle St
Suite 200
Boise, ID 83702-6970

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912001073 ID Practitioner - Sports MedicinePractitioner - Family Practice 4789617689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
University of Utah School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

2619 W Fairview Ave
Boise, ID 83702-6722
Phone (208) 706-2676

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 Hospital, Boise, ID, CCN 130006
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8827IDMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 1, 2012 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 1, 2012 Accepting new patients
Boise Radiology Group PLLC Past Accepting new patients
Intermountain Orthopaedics Specialists Past Accepting new patients
Intermountain Orthopaedic PLLC Past Accepting new patients
Mountain States Medical Group PA Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Luke'S Regional Medical Center Past Accepting new patients

Locations

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

600 N Robbins Rd
Ste 401
Boise, ID 83702
Phone (208) 489-4279

600 N Robbins Rd
Ste 100
Boise, ID 83702
Phone (208) 381-9037

2619 W Fairview Ave
Fl 1
Boise, ID 83702

1109 W Myrtle St
Ste 200
Boise, ID 83702
Phone (208) 706-6375

2619 W Fairview Ave
Fl 2
Boise, ID 83702

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

2619 W Fairview Ave
#1103
Boise, ID 83702

Interoperability endpoints

  • Direct secure messaging: knilsson15386@direct.slhs.org

Organizations & group practices 8

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.

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1477581122",
    "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": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W MYRTLE ST",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026970",
            "telephone_number": "208-383-0201",
            "fax_number": "208-489-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "KURT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ID",
            "license": "M8827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.