Individual provider Active NPI

Sean Steven Vasas

  • Internal Medicine Physician
  • Boise, ID
National Provider Identifier
1669310546
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3681308 Issued in ID
Practice address
500 W Fort St # 111R
Boise, ID 83702-4599
Phone
(208) 422-1000
NPI assigned
Mar 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3681308 ID Primary

Addresses

Primary practice location

500 W Fort St # 111R
Boise, ID 83702-4599

Mailing address

500 W Fort St # 111R
Boise, ID 83702-4599
Phone (208) 422-1000

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
I20260512003941 ID Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1254800931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1669310546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111R",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024599",
            "telephone_number": "208-422-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111R",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024599",
            "telephone_number": "208-422-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASAS",
        "first_name": "SEAN",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "3681308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.