Daniel Rulon Anderson – Psychiatry Physician

Key facts

NPI: 1790518751
Entity type: Individual (NPI type 1)
Primary specialty: Psychiatry Physician 2084P0800X
License: 1361470 (ID)
Practice address: 715 Brampton Dr
Caldwell, ID 83605-6887
Phone: (208) 960-0559
NPI assigned: Aug 23, 2024
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Meridian Advanced Psychiatry , LLC Addiction Medicine (Psychiatry & Neurology) Physician · Meridan, ID · NPI 1609412683

Medicare reassignment Care Compare group NPD ID

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2024
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Meridian Advanced Psychiatry , LLC (25 clinicians)

Practice addresses (Care Compare)

1672 S Woodsage Ave
Suite 120
Meridian, ID 83642-7670
Phone (208) 515-2273

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: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20241122003668	ID	Practitioner - Nurse Practitioner	2769917061	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
1361470	ID	MD	Psychiatry Physician

Practice roles

Organization	Specialty	Status	New patients
Meridian Advanced Psychiatry , LLC		Current since Nov 1, 2024	Accepting new patients

Locations

211 E Logan St
Ste 301
Caldwell, ID 83605

1672 S Woodsage Ave
Ste 120
Meridian, ID 83642
Phone (208) 515-2273

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychiatry Physician	2084P0800X	1361470	ID	Yes

Addresses

Primary practice location

715 Brampton Dr
Caldwell, ID 83605-6887

Mailing address

715 Brampton Dr
Caldwell, ID 83605-6887
Phone (208) 960-0559

Other providers in Caldwell, ID

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Ametrine Counseling and Wellness, LLP
Beth Larae Amos, C.F.A
Anchor Place, LLC
Ciara Joann Anderson, LMSW
Ian Kenneth Anderson, PHARMD
Robert Jay Anderson, PHARMD, RPH.
Anesthesia Consulting Partners Idaho, PC
Stephen Annest, LCSW-40176
Christina L Anthony

All providers in Caldwell, ID · Psychiatry 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 Aug 23, 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).
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.

Verify at the official NPI Registry.