Individual provider Active NPI

Dinu Mistry Wolf, MD

  • Plastic Surgery Physician
  • Boise, ID
National Provider Identifier
1811943285
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
M8327 Issued in ID
Practice address
341 E Bannock St
Boise, ID 83712-6208
Phone
(208) 342-8180
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X M8327 ID Primary

Addresses

Primary practice location

341 E Bannock St
Boise, ID 83712-6208

Mailing address

341 E Bannock St
Boise, ID 83712-6208
Phone (208) 342-8180

Other names 1

  • Dinu G Mistry Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027000126 ID Practitioner - Plastic and Reconstructive Surgery 5890712061

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Washington University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

190 E Bannock St
Boise, ID 83712-6241

341 E Bannock St
Boise, ID 83712-6208

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8327IDMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 30, 2019 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 30, 2019 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: dmistry28815@direct.slhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1811943285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126208",
            "telephone_number": "208-342-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126208",
            "telephone_number": "208-342-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY WOLF",
        "first_name": "DINU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "ID",
            "license": "M8327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DINU",
            "last_name": "MISTRY",
            "middle_name": "G",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.