Individual provider Active NPI

Russell W Wright, MD

  • Diagnostic Radiology Physician
  • Boise, ID
National Provider Identifier
1679710123
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M-11892 Issued in ID
Practice address
190 E Bannock St
C/O Boise Radiology Group
Boise, ID 83712-6241
Phone
(208) 381-2094
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X N1961 TX
Diagnostic Radiology Physician 2085R0202X M-11892 ID Primary
Body Imaging Physician 2085B0100X 250292 MA

Addresses

Primary practice location

190 E Bannock St
C/O Boise Radiology Group
Boise, ID 83712-6241

Mailing address

115 W Main St Ste 202
Boise, ID 83702-7303
Phone (208) 433-9466

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
I20130716000100 ID Practitioner - Diagnostic Radiology 2860648649 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians
Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 549-0370

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
92.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250292MAMDBody Imaging Physician
N1961TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center, Inc. CurrentSince May 17, 2014 Accepting new patients
Weiser Valley Hospital District Diagnostic Radiology CurrentSince Jul 20, 2013 Accepting new patients
North Canyon Medical Center Inc. CurrentSince Oct 1, 2025 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince May 17, 2014 Accepting new patients
Weiser Valley Hospital District CurrentSince Jul 20, 2013 Accepting new patients
Boise Radiology Group PLLC Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Aug 24, 2013 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

703 S Americana Blvd
Boise, ID 83702
Phone (208) 706-6375

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

1000 E Park Blvd
Boise, ID 83712
Phone (208) 381-4100

600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444

115 W Main St
Ste 202
Boise, ID 83702
Phone (208) 433-9466

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

3101 E State St
Eagle, ID 83616
Phone (208) 473-3100

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

Organizations & group practices 8

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1679710123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W MAIN ST STE 202",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027303",
            "telephone_number": "208-433-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "address_2": "C/O BOISE RADIOLOGY GROUP",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "RUSSELL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N1961",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-11892",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MA",
            "license": "250292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.