Active NPI
Kenneth Verlage
- Urology Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- M-17493
- Practice address
- 510 N 2ND St Ste 102
Boise, ID 83702-6077 - Phone
- (208) 381-4700
- NPI assigned
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | M-17493 | ID | Primary |
| Urology Physician | 208800000X | MD210158 | OR |
Addresses
Primary practice location
510 N 2ND St Ste 102
Boise, ID 83702-6077
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
501 N Graham St Ste 420
Portland, OR 97227-2006
Phone (503) 288-7303
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | referringaua@orclinic.direct-ci.net | Oregon Clinic PC |
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
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Texas Tech University Health Science Center School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384
510 N 2ND St
Suite 103
Boise, ID 83702-6081
Phone (208) 381-4700
520 S Eagle Rd
Meridian, ID 83642-6351
520 S Eagle Rd
Meridian, ID 83642-6352
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711
9850 St Lukes Dr
Nampa, ID 83687-7912
9850 W St Luke'S Dr
Nampa, ID 83687-7912
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S Elmore Medical Center
- St Luke'S Nampa Medical Center
- St Lukes Magic Valley Medical Center
- St Luke'S McCall
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 21 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-17493 | ID | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
520 S Eagle Rd
Ste 3112
Meridian, ID 83642
Phone (208) 706-5800
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- McCall, ID
- NPI 1235447970
-
- Critical Access Hospital
- Mountain Home, ID
- NPI 1699013565
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
-
- General Acute Care Hospital
- Twin Falls, ID
- NPI 1932154705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1730620907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 N 2ND ST STE 102",
"city": "BOISE",
"state": "ID",
"postal_code": "837026077",
"telephone_number": "208-381-4700"
}
],
"practiceLocations": [
{
"address_1": "501 N Graham St Ste 420",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972272006",
"country_code": "US",
"telephone_number": "503-288-7303",
"fax_number": "503-288-3806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VERLAGE",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "ID",
"license": "M-17493",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OR",
"license": "MD210158",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "referringaua@orclinic.direct-ci.net",
"affiliation": "Y",
"affiliationName": "Oregon Clinic PC",
"address_1": "501 N Graham St Ste 420",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972272006",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.