NPIMap

Individual provider Active NPI

Duncan Dwaynne Harris, M.D.

  • Urology Physician
  • Idaho Falls, ID
National Provider Identifier
1679528632
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G77559 Issued in CA
Practice address
3200 Channing Way Ste A205
Idaho Falls, ID 83404-7586
Phone
(208) 535-4580
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G77559 CA Primary

Addresses

Primary practice location

3200 Channing Way Ste A205
Idaho Falls, ID 83404-7586

Mailing address

PO Box 277381
Atlanta, GA 30384-7381

Other practice location 1

3200 Channing Way Ste 202
Idaho Falls, ID 83404
Phone (208) 535-4580

Other identifiers 1

IdentifierTypeStateIssuer
00G775590MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812002193 WA Practitioner - Urology 9133146236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loma Linda University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Memorial HospitalGroup PAC ID 4082502422, shared by 3 NPIs, 33 clinicians

Practice addresses (Care Compare)

1119 Highland Ave
Clarkston, WA 99403-2836
Phone (509) 758-5511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50541CAMDUrology Physician
G77559CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Memorial Hospital Urology CurrentSince Aug 1, 2022 Accepting new patients
Tri-State Memorial Hospital CurrentSince Jan 1, 2026 Accepting new patients
Tri-State Memorial Hospital CurrentSince Aug 1, 2022 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Locations

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

1119 Highland Ave
Ste 1
Clarkston, WA 99403
Phone (509) 254-2722

1100 Highland Ave
Clarkston, WA 99403
Phone (509) 758-2568

1119 Highland Ave
Clarkston, WA 99403
Phone (509) 758-1450

Interoperability endpoints

  • Direct secure messaging: duncan.harris@tsmh.medicity.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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679528632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277381",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE A205",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047586",
            "telephone_number": "208-535-4580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Channing Way Ste 202",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "83404",
            "country_code": "US",
            "telephone_number": "208-535-4580",
            "fax_number": "208-535-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DUNCAN",
        "middle_name": "DWAYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-09-11",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G77559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G775590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.