NPIMap

Individual provider Active NPI

Monika Gerda Fealko, MD

  • Obstetrics & Gynecology Physician
  • Boise, ID
National Provider Identifier
1801891569
Registry record updated Sep 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-10332 Issued in ID
Practice address
333 N. First St
Suite 240
Boise, ID 83702
Phone
(208) 338-8900
Fax
(208) 331-2418
NPI assigned
Jun 17, 2005
Last updated
Sep 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35079854F OH
Obstetrics & Gynecology Physician 207V00000X M-10332 ID Primary

Addresses

Primary practice location

333 N. First St
Suite 240
Boise, ID 83702

Mailing address

333 N. First St
Suite 240
Boise, ID 83702
Phone (208) 338-8900

Other identifiers 3

IdentifierTypeStateIssuer
2386636MedicaidOH
808110100MedicaidID
P00108848OtherRAILROAD MEDICARE

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
I20090409000097 ID Practitioner - Obstetrics/Gynecology 4587711510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women's Health Associates, PLLCGroup PAC ID 4082630587, 19 clinicians

Practice addresses (Care Compare)

333 N 1St St
Boise, ID 83702-6132
Phone (208) 338-8900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35079854FOHMDSpecialist
M-10332IDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Health Associates, PLLC Obstetrics & Gynecology CurrentSince May 4, 2010 Accepting new patients
Shipman,Eucker and Associates Obstetrics & Gynecology Past Accepting new patients

Locations

333 N 1st St
Ste 240
Boise, ID 83702
Phone (208) 338-8900

3090 E Gentry Way
Ste 210
Meridian, ID 83642
Phone (208) 338-8900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220313600000",
    "number": "1801891569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N. FIRST ST",
            "address_2": "SUITE 240",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-338-8900",
            "fax_number": "208-331-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N. FIRST ST",
            "address_2": "SUITE 240",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-338-8900",
            "fax_number": "208-331-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEALKO",
        "first_name": "MONIKA",
        "middle_name": "GERDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35079854F",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-10332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2386636",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808110100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00108848",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.