NPIMap

Individual provider Active NPI

Andrew Dysart, MD

  • Hematology & Oncology Physician
  • Boise, ID
National Provider Identifier
1821674995
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
6561374 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-7350
NPI assigned
Mar 19, 2021
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 6561374 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1200 NW 23rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

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
I20241127001914 ID Practitioner - Hematology/Oncology 1557761418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: adysart3728817@direct.trinity-health.org

Organizations & group practices 3

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 5

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": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1821674995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-7350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 NW 23rd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972102906",
            "country_code": "US",
            "telephone_number": "503-413-7074",
            "fax_number": "503-413-6892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYSART",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "6561374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.