NPIMap

Organization Active NPI

Ronald E Jutzy MD Inc

  • Neurological Surgery Physician
  • Boise, ID
National Provider Identifier
1811906076
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M5302 Issued in ID
Legal business name
RONALD E JUTZY MD INC
Practice address
6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880
Phone
(208) 367-3500
Fax
(208) 367-2968
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Ronald E Jutzy, MDNPI 1427070929
Title
Owner
Phone
(208) 367-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X M5302 ID Primary

Addresses

Primary practice location

6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880

Mailing address

6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880
Phone (208) 367-3500

Other identifiers 7

IdentifierTypeStateIssuer
806667900MedicaidID
202662100OtherU S DEPARTMENT OF LABOR
72439OtherIDBLUE CROSS OF IDAHO
003530200MedicaidID
8K321OtherIDBLUE CROSS OF IDAHO GROUP
190686OtherOROMAP
12OtherWAWA DEPARTMENT OF LABOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1811906076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 CURTISIAN AVE",
            "address_2": "SUITE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048880",
            "telephone_number": "208-367-3500",
            "fax_number": "208-367-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 CURTISIAN AVE",
            "address_2": "SUITE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048880",
            "telephone_number": "208-367-3500",
            "fax_number": "208-367-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD E JUTZY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "JUTZY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-367-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M5302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806667900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U S DEPARTMENT OF LABOR",
            "identifier": "202662100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "72439",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003530200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO GROUP",
            "identifier": "8K321",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "190686",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPARTMENT OF LABOR",
            "identifier": "12",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.