Individual provider Active NPI

David W Wood, M.D.

  • Gastroenterology Physician
  • Boise, ID
National Provider Identifier
1659367993
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M-7913 Issued in ID
Practice address
425 W Bannock St
Boise, ID 83702-6035
Phone
(208) 343-6458
Fax
(208) 343-5031
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X M-7913 ID Primary

Addresses

Primary practice location

425 W Bannock St
Boise, ID 83702-6035

Mailing address

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 343-1702

Other practice location 1

9850 St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 343-6458

Other practice location 2

2235 E Gala St
Meridian, ID 83642-8026
Phone (208) 887-3724

Other practice location 3

1200 Garrity Blvd
Nampa, ID 83687-3402
Phone (208) 343-6458

Other identifiers 4

IdentifierTypeStateIssuer
000010137531OtherIDBLUE SHIELD OF IDAHO
805634500MedicaidID
J5818OtherIDBLUE CROSS OF IDAHO
P00077694OtherIDRAILROAD MEDICARE

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
I20101005001300 ID Practitioner - GastroenterologyPractitioner - Internal Medicine 2365469939 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Cincinnati College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Gastroenterology Associates LLPGroup PAC ID 6002708773, 35 clinicians

Practice addresses (Care Compare)

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 489-1431

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Upper gastrointestinal (GI) endoscopy for acid reflux11

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: davidwood@igallp.allscriptsdirect.net

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1659367993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026035",
            "telephone_number": "208-343-1702",
            "fax_number": "208-342-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026035",
            "telephone_number": "208-343-6458",
            "fax_number": "208-343-5031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9850 St Lukes Dr",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836877912",
            "country_code": "US",
            "telephone_number": "208-343-6458",
            "fax_number": "208-343-5031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2235 E Gala St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428026",
            "country_code": "US",
            "telephone_number": "208-887-3724",
            "fax_number": "208-887-1682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Garrity Blvd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836873402",
            "country_code": "US",
            "telephone_number": "208-343-6458",
            "fax_number": "208-343-5031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M-7913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010137531",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805634500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "J5818",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00077694",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.