Keenan Baptista, DO
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Boise, ID
NPI 1730884693 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1730884693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 500 W Fort St BLDG 116
Boise, ID 83702-4501 - Phone
- (208) 422-1165
- NPI assigned
- Mar 31, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| I20230629001424 | ID | Order and Referring Only - Psychiatry |
8921467507 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
500 W Fort St BLDG 116
Boise, ID 83702-4501
Mailing address
500 W Fort St BLDG 116
Boise, ID 83702-4501
Phone (208) 422-1165
Other providers in Boise, ID
- Jeffrey Steven Bank
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- Ianitza Bankova
- Courtney Hobza Bannick
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- Mark Edward Baradziej
- Jacqueline Barajas
- Kenneth G Baranco
- Aleksandra Baranova
- Francesca Barbaro
All providers in Boise, ID · Student in an Organized Health Care Education/Training Program in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.