Individual provider Active NPI

Alan J.a. Pitt, MD

  • Dermatology Physician
  • Meridian, ID
National Provider Identifier
1659301950
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M7850 Issued in ID
Practice address
1618 S. Millennium Way
Suite 100
Meridian, ID 83642-6457
Phone
(208) 884-3376
Fax
(208) 884-0858
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X M7850 ID Primary

Addresses

Primary practice location

1618 S. Millennium Way
Suite 100
Meridian, ID 83642-6457

Mailing address

1618 S. Millennium Way
Suite 100
Meridian, ID 83642-6457
Phone (208) 884-3376

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alan1@adawest.emadirect.md Direct

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
I20051201000711 ID Practitioner - Dermatology 4880614114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
55.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7850IDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ada West Dermatology, PC Dermatology CurrentSince Jan 1, 2006 Accepting new patients
Alan J a Pitt MD P a Dermatology PastSince Aug 5, 1999 Accepting new patients
Ada West Dermatopathology, LLC PastSince Sep 26, 2012 Accepting new patients
Mofid Clinic of Chiropractic, LLC PastSince Feb 22, 2016 Accepting new patients

Locations

1618 S Millenium Way
Ste 100
Meridian, ID 83642
Phone (208) 884-3376

Interoperability endpoints

  • Direct secure messaging: alan1@adawest.emadirect.md

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1659301950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 S. MILLENNIUM WAY",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S. MILLENNIUM WAY",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITT",
        "first_name": "ALAN",
        "middle_name": "J.A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M7850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alan1@adawest.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1618 S. Millennium Way",
            "address_2": "Suite 100",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836426457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.