Individual provider Active NPI

Cydney L Fenton, M.D.

  • Pediatric Endocrinology Physician
  • Boise, ID
National Provider Identifier
1497788921
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
9371240 Issued in ID
Practice address
305 E Jefferson St
Boise, ID 83712-6231
Phone
(208) 381-7340
Fax
(208) 381-7341
NPI assigned
Jul 8, 2006
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 35-086582 OH
Pediatric Endocrinology Physician 2080P0205X 102575 AK
Pediatric Endocrinology Physician 2080P0205X 9371240 ID Primary

Addresses

Primary practice location

305 E Jefferson St
Boise, ID 83712-6231

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

9500 Independence Dr Ste 900
Anchorage, AK 99507-4686
Phone (907) 522-1341

Other identifiers 1

IdentifierTypeStateIssuer
1633473MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250213003860 ID Practitioner - Pediatric Medicine 4385675909 Reassigns benefits to 1 organization
I20260109001552 TX Practitioner - Pediatric Medicine 4385675909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7033 E Tudor Rd
Anchorage, AK 99507-1262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9371240IDMDPediatric Endocrinology Physician
35-086582OHMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Feb 7, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Feb 7, 2025 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jan 1, 2026 Accepting new patients
Southcentral Foundation CurrentSince Jan 1, 2026 Accepting new patients
Southcentral Foundation CurrentSince Jan 1, 2026 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

400 W Benson Blvd
Anchorage, AK 99503
Phone (907) 729-4654

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Ste 2300
Anchorage, AK 99508
Phone (907) 729-1000

3503 E Meridian Park Loop
Ste 220 Alaska Subspecialty Pediatric Network
Wasilla, AK 99654
Phone (907) 729-5083

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

305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715

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

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1497788921",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126231",
            "telephone_number": "208-381-7340",
            "fax_number": "208-381-7341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Independence Dr Ste 900",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995074686",
            "country_code": "US",
            "telephone_number": "907-522-1341",
            "fax_number": "907-522-1343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTON",
        "first_name": "CYDNEY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35-086582",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "AK",
            "license": "102575",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "ID",
            "license": "9371240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1633473",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.