Jeffery J Eidson, MD
Individual provider Active NPI Anesthesiology Physician · Boise, ID
NPI 1760428544 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760428544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- M7232 (ID)
- Practice address
- 111 W State St
Boise, ID 83702-6127 - Phone
- (208) 336-0895
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- University of New Mexico School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Associates of Boise, P.a.
Practice addresses (Care Compare)
338 E Bannock St
Boise, ID 83712-6207
Phone (208) 336-0895
Hospital & facility affiliations
- St Luke'S Regional Medical Center
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 |
|---|---|---|---|---|
| I20100831000660 | ID | Practitioner - Anesthesiology | 9537283320 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M7232 | ID | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Boise, P.a. | Current |
Accepting new patients |
Locations
338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895
2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | M7232 | ID | Yes |
Addresses
Primary practice location
111 W State St
Boise, ID 83702-6127
Mailing address
111 W State St
Boise, ID 83702-6127
Phone (208) 336-0895
Other providers in Boise, ID
- Jayson Egwuonwu
- Kimberly Ehlke
- Carrie Eichberg
- Alison Carroll Eichenlaub
- Thomas Eicher Jr.
- Amaya Aurora Eiguren
- Linda Sue Eiler
- April Eilers-Isla
- Charles E Eiriksson Jr.
- Erika Leigh Eisele
All providers in Boise, ID · Anesthesiology Physician 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 8, 2007. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.