Individual provider Active NPI

Rene Robert Alamo, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1558083402
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
78341 Issued in ID
Practice address
11048 W Victoria Dr
Nampa, ID 83686-6755
Phone
(208) 546-9264
Fax
(208) 203-7006
NPI assigned
Sep 16, 2022
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 78341 ID Primary

Addresses

Primary practice location

11048 W Victoria Dr
Nampa, ID 83686-6755

Mailing address

11048 W Victoria Dr
Nampa, ID 83686-6755
Phone (208) 546-9264

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211003646 ID Practitioner - Nurse Practitioner 9436685641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthcare With Heart LLCGroup PAC ID 2062463979, 6 clinicians

Practice addresses (Care Compare)

823 Ctr Ave
Payette, ID 83661-2535
Phone (208) 642-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78341IDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare With Heart LLC CurrentSince Nov 25, 2024 Accepting new patients
Perma Mental Health PLLC PastSince Jan 1, 2024 Accepting new patients

Locations

823 Center Ave
Payette, ID 83661
Phone (208) 642-1333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8016/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rene.alamo.1@8016.direct.athenahealth.com

Organizations & group practices 2

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1558083402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11048 W VICTORIA DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866755",
            "telephone_number": "208-546-9264",
            "fax_number": "208-203-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11048 W VICTORIA DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866755",
            "telephone_number": "208-546-9264",
            "fax_number": "208-203-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAMO",
        "first_name": "RENE",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "78341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.