NPIMap

Individual provider Active NPI

Graham Charles Hall, MD

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1730317090
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M-15928 Issued in ID
Practice address
1072 N Liberty St Ste 200
Boise, ID 83704-8963
Phone
(208) 302-4100
Fax
(208) 302-4135
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 01080885A IN
Surgery Physician 208600000X 47390 KY
Neurological Surgery Physician 207T00000X M-15928 ID Primary

Addresses

Primary practice location

1072 N Liberty St Ste 200
Boise, ID 83704-8963

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1550 E County Line Rd Ste 201
Indianapolis, IN 46227-1082
Phone (317) 355-1470

Other identifiers 2

IdentifierTypeStateIssuer
7100142170MedicaidKY
300018084MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ghall322977@eCommunityDirect.com Community Physicians of Indiana Inc

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
I20210913000960 ID Practitioner - Neurosurgery 6204147010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1055 N Curtis
Boise, ID 83706-1309

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

1072 N Liberty St
Boise, ID 83704-8708

3025 W Cherry LN
Meridian, ID 83642-8531

4424 E Flamingo Ave
Nampa, ID 83687-9306

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion70
Laminectomy or laminotomy (partial removal of spine bones)35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47390KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Oct 30, 2021 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Neurological Surgery Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Oct 30, 2021 Accepting new patients
Major Hospital Past Accepting new patients
Saint Alphonsus Specialty Services Inc Neurological Surgery PastSince Jul 23, 2023 Accepting new patients

Locations

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

1072 N Liberty St
Ste 200
Boise, ID 83704
Phone (208) 302-4100

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

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

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

Interoperability endpoints

  • Direct secure messaging: ghall322977@ecommunitydirect.com
  • Direct secure messaging: ghall1627420@direct.trinity-health.org

Organizations & group practices 5

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 10

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1730317090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048963",
            "telephone_number": "208-302-4100",
            "fax_number": "208-302-4135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 E County Line Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462271082",
            "country_code": "US",
            "telephone_number": "317-355-1470",
            "fax_number": "317-355-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "GRAHAM",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01080885A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "47390",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M-15928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100142170",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300018084",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghall322977@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1550 E County Line Rd Ste 201",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462271082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.