Individual provider Active NPI

Alpha Tamir Anders, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Meridian, ID
National Provider Identifier
1508493230
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A193769 Issued in CA
Practice address
520 S Eagle Rd Ste 2207
Meridian, ID 83642-6354
Phone
(208) 947-2266
Fax
(208) 947-2267
NPI assigned
Mar 24, 2020
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 323605 LA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 7771956 ID
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A193769 CA Primary

Addresses

Primary practice location

520 S Eagle Rd Ste 2207
Meridian, ID 83642-6354

Mailing address

9452 Medical Center Dr # 898
La Jolla, CA 92037-1337
Phone (858) 249-3800

Other practice location 1

9400 Campus Point Dr
LA Jolla, CA 92093-1350
Phone (858) 249-3800

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
I20250918004685 ID Practitioner - Pain Management 6204251648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2020
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)

520 S Eagle Rd
Suite 2207
Meridian, ID 83642-6354
Phone (208) 706-6300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323605LAMDPhysical Medicine & Rehabilitation Physician
A193769CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Sep 4, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Sep 4, 2025 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

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

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

520 S Eagle Rd
Ste 2207
Meridian, ID 83642
Phone (208) 288-4588

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1508493230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9452 MEDICAL CENTER DR # 898",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371337",
            "telephone_number": "858-249-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD STE 2207",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426354",
            "telephone_number": "208-947-2266",
            "fax_number": "208-947-2267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9400 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920931350",
            "country_code": "US",
            "telephone_number": "858-249-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "ALPHA",
        "middle_name": "TAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "323605",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "ID",
            "license": "7771956",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A193769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.