John E Gamboa, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

M5607 Issued in ID

Practice address

9357 W Emerald St
Boise, ID 83704-9752

Phone

(208) 672-1000

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medical Oncology Associates, PS

  • Radiation Oncology Physician
  • Spokane Valley, WA
  • NPI 1831524073
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1477597045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9357 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049752",
            "telephone_number": "208-672-1000",
            "fax_number": "208-672-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9357 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049752",
            "telephone_number": "208-672-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ID",
            "license": "M5607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002745400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Ann Galvez, M.D.
• Melodie Karol Galyen, M.S., L.P.C.
• Jessica Nicole Gambill, LCSW
• Melanie Ellen Gambill, PT, DPT
• Belinda Estolia Gamboa, M. COUN, LCPC
• Nicholas T. Gamboa, M.D.
• Jennifer Games, PT, L. AC.
• Peter Games, L. AC.
• Elizabeth Anne Gammill
• Christopher D Gammon, OTR

• Radiation Oncology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Radiation Oncology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.