Delray Maughan, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

M4908 Issued in ID

Practice address

13900 W Wainwright Dr Ste 102
Boise, ID 83713-5028

Phone

(208) 938-5823

Fax

(208) 938-5306

NPI assigned

Nov 29, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Idaho Ear Clinic, PLLC

  • Otology & Neurotology Physician
  • Meridian, ID
  • NPI 1154976983
  Medicare reassignment NPD

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1649253188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 W WAINWRIGHT DR STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135028",
            "telephone_number": "208-938-5823",
            "fax_number": "208-938-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 W WAINWRIGHT DR STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135028",
            "telephone_number": "208-938-5823",
            "fax_number": "208-938-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUGHAN",
        "first_name": "DELRAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ID",
            "license": "M4908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002592700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy L Mattise, CRNA
• Hallie Shaye Mattson
• John C Matunas, DDS
• Larissa Marie Mauer
• Maddi Alizabeth Maughan-Ames
• Gunnar Harrison Maughan, MSPO, CPO
• Kyle Donovan Maughan, DPT
• Kalyn C Mauk, CMT
• Spencer O Mauk
• Steven A Mauk, LCP

• Otolaryngology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Otolaryngology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.