Active NPI
Madison Mansfield, MD
- Family Medicine Physician
- Nampa, ID
National Provider Identifier
1689466930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9071163
- Practice address
- 9850 W St Lukes Dr # 329
Nampa, ID 83687-7912 - Phone
- (208) 514-2509
- Fax
- (208) 375-2217
- NPI assigned
- May 21, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9071163 | ID | Primary |
Addresses
Primary practice location
9850 W St Lukes Dr # 329
Nampa, ID 83687-7912
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250715002658 | ID | Order and Referring Only - Family Practice | 8224543558 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Past | Accepting new patients |
Interoperability endpoints
- mmansfield789528@direct.ochin.org
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Boise, ID
- NPI 1841490075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1689466930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 W ST LUKES DR # 329",
"city": "NAMPA",
"state": "ID",
"postal_code": "836877912",
"telephone_number": "208-514-2509",
"fax_number": "208-375-2217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSFIELD",
"first_name": "MADISON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-21",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "9071163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.