Active NPI
Tamra Katherine Geryk, FNP-C
- Family Nurse Practitioner
- Boise, ID
National Provider Identifier
1487220380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 55636
- Practice address
- 4280 N Ginzel St
Boise, ID 83703-4214 - Phone
- (413) 687-3027
- Fax
- (208) 254-4895
- NPI assigned
- Jun 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 55636 | ID | Primary |
Addresses
Primary practice location
4280 N Ginzel St
Boise, ID 83703-4214
Mailing address
4280 N Ginzel St
Boise, ID 83703-4214
Phone (307) 690-4748
Other practice location 1
2939 W Excursion Ln
Meridian, ID 83642-5308
Phone (208) 385-7711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deva Wellness PLLC | Family | Current | Accepting new patients |
| Functional Medicine of Idaho PC | Past | Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Past | Accepting new patients |
Organizations & group practices 3
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 Nurse Practitioner
- Boise, ID
- NPI 1043055338
-
- Family Medicine Physician
- Boise, ID
- NPI 1336656040
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1487220380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4280 N GINZEL ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837034214",
"telephone_number": "307-690-4748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4280 N GINZEL ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837034214",
"telephone_number": "413-687-3027",
"fax_number": "208-254-4895"
}
],
"practiceLocations": [
{
"address_1": "2939 W Excursion Ln",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "ID",
"postal_code": "836425308",
"country_code": "US",
"telephone_number": "208-385-7711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERYK",
"first_name": "TAMRA",
"middle_name": "KATHERINE",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-01",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "55636",
"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 May 19, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.