Individual provider Active NPI

Mark A Henzler, M.D.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1518904598
Registry record updated Oct 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M5418 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1352
Phone
(208) 322-1730
Fax
(208) 322-1731
NPI assigned
May 31, 2006
Last updated
Oct 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M5418 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1352

Mailing address

2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055
Phone (208) 322-1730

Other identifiers 1

IdentifierTypeStateIssuer
003741300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20170412001021 HI Practitioner - Emergency Medicine 5496831315 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maui Memorial Emergency Medical Associates IncGroup PAC ID 7618224981, 23 clinicians

Practice addresses (Care Compare)

100 Keokea PL
Kula, HI 96790-7450
Phone (808) 878-1221

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC Current Accepting new patients
Maui Memorial Emergency Medical Associates Inc Emergency Medicine CurrentSince Jul 18, 2025 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 1, 2017 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 1, 2017 Accepting new patients
Lanai Emergency Medical Associates Inc Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

100 Keokea Pl
Kula, HI 96790
Phone (808) 875-6690

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

Organizations & group practices 5

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 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791072000000",
    "number": "1518904598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061352",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZLER",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M5418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003741300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.