Elizabeth E Atnip, MD
Individual provider Active NPI Family Medicine Physician · Boise, ID
NPI 1730568262 · NPPES record last updated Dec 15, 2023
Key facts
- NPI
- 1730568262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-13445 (ID)
- Practice address
- 325 W Idaho St
Boise, ID 83702-6040 - Phone
- (208) 514-2525
- Fax
- (208) 375-2217
- NPI assigned
- May 29, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Pennsylvania State University College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Full Circle Health Inc
Practice addresses (Care Compare)
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
- St Luke'S Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180717003470 | ID | Practitioner - Family Practice | 4587970637 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-13445 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current |
Accepting new patients | |
| St Lukes Regional Medical Center | Past |
Accepting new patients |
Locations
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
325 W Idaho St
Boise, ID 83702
Phone (208) 514-2525
6565 W Emerald St
Boise, ID 83704
Phone (208) 377-5055
2275 S Eagle Rd
Ste 120
Meridian, ID 83642
Phone (208) 514-2520
Interoperability endpoints
- eatnip1563133@direct.trinity-health.org
- eatnip295090@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MRM-1470 | ID | |
| Family Medicine Physician | 207Q00000X | M-13445 | ID | Yes |
Addresses
Primary practice location
325 W Idaho St
Boise, ID 83702-6040
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730568262 | Medicaid | ID |
Other providers in Boise, ID
- Irma Calnon Atkinson
- Jacob Atkinson
- Kristie Rachele Atkinson
- Atlantis Dental Care, P.a.
- Atlas Home Care LLC
- Ats Wheelchair Co., Inc.
- Auburn Crest Hospice Treasure Valley, LLC
- Augustine Behavioral Health LLC
- Elizabeth Augustine
- Susan Eliane Ault
All providers in Boise, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.