Individual provider Active NPI

Aaron Blue, MD, MSC

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1639465115
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.143036 Issued in IL
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-2222
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A131236 CA
Emergency Medicine Physician 207P00000X M-13202 ID
Emergency Medicine Physician 207P00000X 036.143036 IL Primary

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

13960 W Wainwright Dr
Boise, ID 83713-1969
Phone (208) 381-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140925001469 CA Practitioner - Emergency Medicine 7214157254 Reassigns benefits to 2 organizations
I20230501000949 WA Practitioner - Emergency Medicine 7214157254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A131236CAMDEmergency Medicine Physician
036.143036ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Jul 15, 2014 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639465115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13960 W WAINWRIGHT DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131969",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "MD, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A131236",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-13202",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.143036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.