Individual provider Active NPI

Kaden Lyde Facer, MD

  • Psychiatry Physician
  • Meridian, ID
National Provider Identifier
1740819986
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M-17652 Issued in ID
Practice address
2273 E Gala St Ste 100
Meridian, ID 83642-7289
Phone
(208) 898-8999
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M-17652 ID Primary

Addresses

Primary practice location

2273 E Gala St Ste 100
Meridian, ID 83642-7289

Mailing address

2273 E Gala St Ste 100
Meridian, ID 83642-7289
Phone (208) 898-8999

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306000685 ID Order and Referring Only - PsychiatryPractitioner - Psychiatry 7911428974

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Psychological Services, PLLC PastSince Mar 30, 2025 Accepting new patients
Scott P. Hoopes, M.D., P.a. Psychiatry PastSince Mar 30, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1740819986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 E GALA ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427289",
            "telephone_number": "208-898-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 E GALA ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427289",
            "telephone_number": "208-898-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACER",
        "first_name": "KADEN",
        "middle_name": "LYDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-17652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.