NPIMap

Individual provider Active NPI

Tiffany C Heidt, NP

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1689683518
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
N-34138 Issued in ID
Practice address
900 N Liberty St Ste 201
Boise, ID 83704-8707
Phone
(208) 367-6740
Fax
(208) 367-6742
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X N-34138 ID Primary

Addresses

Primary practice location

900 N Liberty St Ste 201
Boise, ID 83704-8707

Mailing address

PO Box 4143
Boise, ID 83711-4143
Phone (208) 367-6740

Other identifiers 1

IdentifierTypeStateIssuer
807326000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20051031000104 ID Practitioner - Nurse Practitioner 0547247603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Valley Endocrinology PCGroup PAC ID 0042237117, 2 clinicians

Practice addresses (Care Compare)

900 N Liberty St
Suite 201
Boise, ID 83704-8707
Phone (208) 367-6740

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N-34138IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Valley Endocrinology PC CurrentSince Oct 1, 2005 Accepting new patients

Locations

900 N Liberty St
Ste 201
Boise, ID 83704
Phone (208) 367-6740

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.

Hospital & facility affiliations 11

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1689683518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4143",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837114143",
            "telephone_number": "208-367-6740",
            "fax_number": "208-367-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N LIBERTY ST STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048707",
            "telephone_number": "208-367-6740",
            "fax_number": "208-367-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDT",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N-34138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807326000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.