NPIMap

Individual provider Active NPI

Kristen Fiorentino, M.D.

  • Internal Medicine Physician
  • Meridian, ID
National Provider Identifier
1760434302
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8929 Issued in ID
Practice address
520 S Eagle Rd Ste 2104
Meridian, ID 83642-6363
Phone
(208) 706-0201
Fax
(208) 706-0202
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 M8929 ID Primary

Addresses

Primary practice location

520 S Eagle Rd Ste 2104
Meridian, ID 83642-6363

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8752

Other practice location 1

223 W State St
St. C
Boise, ID 83702-6013
Phone (208) 994-8656

Other identifiers 1

IdentifierTypeStateIssuer
806862700MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826001375 ID Practitioner - Internal Medicine 1254306970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vibra Physicians LLCGroup PAC ID 8921233933, 30 clinicians

Practice addresses (Care Compare)

6651 W Franklin Rd
Boise, ID 83709-0914
Phone (208) 825-3007

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Vibra Hospital of Boise Long-term care hospital, Boise, ID, CCN 132002

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
M8929IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Jul 1, 2022 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jun 11, 2024 Accepting new patients
Ann Cordum PLLC Internal Medicine Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

6651 W Franklin Rd
Boise, ID 83709
Phone (208) 323-0031

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

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

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

2131 S Bonito Way
Meridian, ID 83642
Phone (208) 202-4700

520 S Eagle Rd
Ste 2104
Meridian, ID 83642
Phone (208) 706-0201

Organizations & group practices 5

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 6

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1760434302",
    "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": "208-381-8752",
            "fax_number": "888-972-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD STE 2104",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426363",
            "telephone_number": "208-706-0201",
            "fax_number": "208-706-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 W State St",
            "address_2": "ST. C",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026013",
            "country_code": "US",
            "telephone_number": "208-994-8656",
            "fax_number": "888-972-4280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIORENTINO",
        "first_name": "KRISTEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806862700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.