Individual provider Active NPI

Tiffany Johnson Beath, FNP-C

  • Nurse Practitioner
  • Boise, ID
National Provider Identifier
1730830746
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
70832 Issued in ID
Practice address
125 E Idaho St Ste 100
Boise, ID 83712-6202
Phone
(208) 338-0148
NPI assigned
Jan 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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 70832 ID Primary

Addresses

Primary practice location

125 E Idaho St Ste 100
Boise, ID 83712-6202

Mailing address

125 E Idaho St Ste 100
Boise, ID 83712-6202
Phone (208) 338-0148

Other practice location 1

3140 W Milano Dr Ste 150
Meridian, ID 83646-7202
Phone (208) 887-4775

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220314000191 ID Practitioner - Nurse Practitioner 7719372580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLC 1,155 clinicians

Practice addresses (Care Compare)

3140 W Milano Dr
Suite 150
Meridian, ID 83646-7202
Phone (208) 887-4775

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 16, 2023 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

125 E Idaho St
Ste 100
Boise, ID 83712
Phone (208) 338-0148

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

Organizations & group practices 4

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 3

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1730830746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E IDAHO ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126202",
            "telephone_number": "208-338-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E IDAHO ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126202",
            "telephone_number": "208-338-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3140 W Milano Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836467202",
            "country_code": "US",
            "telephone_number": "208-887-4775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATH",
        "first_name": "TIFFANY",
        "middle_name": "JOHNSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "70832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.