Individual provider Active NPI

Deborah N Svangstu

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1639282585
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP762A Issued in ID
Practice address
6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880
Phone
(208) 327-5600
Fax
(208) 327-5602
NPI assigned
Aug 16, 2006
Last updated
May 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP762A ID
Nurse Practitioner 363L00000X NP762A ID Primary

Addresses

Primary practice location

6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880

Mailing address

6140 W Curtisian Ave
Ste 400
Boise, ID 83704-8907
Phone (208) 327-5600

Other practice location 1

3875 E Overland Rd
Meridian, ID 83642-9005
Phone (208) 327-5600

Other identifiers 4

IdentifierTypeStateIssuer
807587800MedicaidID
0214273OtherWAWA DEPART OF LABOR
000010158523OtherIDREGENCE BLUESHIELD
NPYA3OtherIDBLUE CROSS OF IDAHO

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
I20070221000533 ID Practitioner - Nurse Practitioner 4880796861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6140 W Curtisian Ave
Suite 400
Boise, ID 83704-8907

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP762AIDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paul J Montalbano MD Past Accepting new patients
Michael V Hajjar MD Past Accepting new patients

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 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1639282585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN AVE",
            "address_2": "STE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048907",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 CURTISIAN AVE",
            "address_2": "SUITE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048880",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3875 E Overland Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836429005",
            "country_code": "US",
            "telephone_number": "208-327-5600",
            "fax_number": "208-327-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SVANGSTU",
        "first_name": "DEBORAH",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP762A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP762A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807587800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPART OF LABOR",
            "identifier": "0214273",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "000010158523",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "NPYA3",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.