Individual provider Active NPI

Shanda Grooms, M.D.

  • Internal Medicine Physician
  • Meridian, ID
National Provider Identifier
1750330080
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8196 Issued in ID
Practice address
520 S Eagle Rd
Ste 3102
Meridian, ID 83642-6351
Phone
(208) 706-5100
Fax
(208) 706-5169
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M8196 ID Primary

Addresses

Primary practice location

520 S Eagle Rd
Ste 3102
Meridian, ID 83642-6351

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

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
I20100724000116 ID Practitioner - Internal Medicine 7113059239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

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

3525 E Louise Dr
Meridian, ID 83642-6305

520 S Eagle Rd
Meridian, ID 83642-6351

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

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M8196IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Mar 1, 2012 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

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

300 E Jefferson St
Ste 300
Boise, ID 83712
Phone (208) 381-4100

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

4840 N Cloverdale Rd
Boise, ID 83713
Phone (208) 706-8000

3101 E State St
Ste 2120
Eagle, ID 83616
Phone (208) 473-3275

520 S Eagle Rd
Ste 3102
Meridian, ID 83642
Phone (208) 331-1155

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

Interoperability endpoints

  • Direct secure messaging: sgrooms16708@direct.slhs.org

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.

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1750330080",
    "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",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "STE 3102",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-706-5100",
            "fax_number": "208-706-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "SHANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.