Individual provider Active NPI

Mark A Rasmus, MD-PULM/SM

  • Specialist
  • Boise, ID
National Provider Identifier
1528106309
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
M-9630 Issued in ID
Practice address
7272 Potomac
Boise, ID 83704
Phone
(208) 884-2922
Fax
(208) 463-3044
NPI assigned
Feb 2, 2007
Last updated
May 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X M-9630 ID Primary
Internal Medicine Physician 207R00000X M9630 ID

Addresses

Primary practice location

7272 Potomac
Boise, ID 83704

Mailing address

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3000

Other identifiers 3

IdentifierTypeStateIssuer
807530600MedicaidID
000010157357OtherIDBLUE SHIELD
76944OtherIDBLUE CROSS

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
I20090803000743 ID Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 1557309879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sleep Wake Idaho PLLCGroup PAC ID 7517406697, 7 clinicians

Practice addresses (Care Compare)

7272 W Potomac Dr
Boise, ID 83704-9149
Phone (208) 884-2922

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9630IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Wake Idaho PLLC Sleep Medicine CurrentSince Jul 31, 2024 Accepting new patients
Southern Idaho Health Partners LLC CurrentSince Apr 1, 2015 Accepting new patients
Tooele Clinic Corp Internal Medicine Past Accepting new patients
Idaho Pulmonary Associates, PA Pulmonary Disease Past Accepting new patients

Locations

7272 W Potomac Dr
Boise, ID 83704
Phone (208) 884-2922

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

217 W Georgia Ave
Ste 115
Nampa, ID 83686
Phone (208) 463-3234

4403 E Flamingo Ave
Nampa, ID 83687
Phone (208) 288-4960

Organizations & group practices 4

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1528106309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-463-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 POTOMAC",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-884-2922",
            "fax_number": "208-463-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUS",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD-PULM/SM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-9630",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M9630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807530600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010157357",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "76944",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.