Individual provider Active NPI

Daniel Allan Bridger, D.O.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1710121926
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-1144 Issued in ID
Practice address
10583 W Lake Hazel Rd
Boise, ID 83709
Phone
(208) 302-5950
NPI assigned
May 1, 2009
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X DO187470 OR
Emergency Medicine Physician 207P00000X 5101018222 MI
Emergency Medicine Physician 207P00000X O-1144 ID Primary

Addresses

Primary practice location

10583 W Lake Hazel Rd
Boise, ID 83709

Mailing address

3340 E Goldstone Dr.
Meridian, ID 83642
Phone (208) 302-5950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180926004248 OR Practitioner - Emergency Medicine 2466695531 Reassigns benefits to 1 organization
I20180928000964 ID Practitioner - Emergency Medicine 2466695531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018222MIMDEmergency Medicine Physician
DO187470ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Apr 1, 2020 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Mar 1, 2020 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Mar 1, 2020 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Apr 1, 2020 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Medical Observation Services, PLLC Emergency Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

10583 W Lake Hazel Rd
Boise, ID 83709
Phone (208) 302-5900

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: dbridger1564293@direct.trinity-health.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1710121926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR.",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10583 W LAKE HAZEL RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-302-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGER",
        "first_name": "DANIEL",
        "middle_name": "ALLAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO187470",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101018222",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.