Alexandra E Beattie, MD
Individual provider Active NPI Family Medicine Physician · Kuna, ID
NPI 1497338685 · NPPES record last updated Oct 13, 2025
Key facts
- NPI
- 1497338685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-17504 (ID)
- Practice address
- 708 E Wythe Creek CT Ste 103
Kuna, ID 83634-5005 - Phone
- (208) 922-5130
- Fax
- (208) 375-2217
- NPI assigned
- May 4, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Full Circle Health Inc
Practice addresses (Care Compare)
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- Saint Alphonsus Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240708003515 | ID | Practitioner - Family Practice | 5496157448 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current |
Accepting new patients |
Locations
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
6565 W Emerald St
Boise, ID 83704
Phone (208) 377-5055
708 E Wythe Creek Ct
Ste 103
Kuna, ID 83634
Phone (208) 922-5130
9850 W St Lukes Dr
Ste 329
Nampa, ID 83687
Phone (208) 331-1155
Interoperability endpoints
- abeattie345195@direct.ochin.org
- alexandra.beattie.d1.p1@direct.idahoarthritis.nextgenshare.com
- alexandra.beattie@cdapeds.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M-17504 | ID | Yes |
Addresses
Primary practice location
708 E Wythe Creek CT Ste 103
Kuna, ID 83634-5005
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Other practice location 1
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
NPI Registry JSON
{
"created_epoch": "1620086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1497338685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 E WYTHE CREEK CT STE 103",
"city": "KUNA",
"state": "ID",
"postal_code": "836345005",
"telephone_number": "208-922-5130",
"fax_number": "208-375-2217"
}
],
"practiceLocations": [
{
"address_1": "777 N Raymond St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837049251",
"country_code": "US",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEATTIE",
"first_name": "ALEXANDRA",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-04",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M-17504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kuna, ID
- Avalon Dental PC
- Jeffrey V Ball
- Stacey Balla
- Dolly Anne Barnes
- Shawn Barrow
- Fawn L. Bell
- Beverley Avril Bellard
- Ivan Belleza
- Kristin Arlene Beltman
- Christopher Daniel Bennett
All providers in Kuna, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.