Active NPI
Heiko Weert De Riese, M.D.
- Psychiatry Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M-16773
- Practice address
- 403 S 11TH St Ste 210
Boise, ID 83702-6968 - Phone
- (208) 381-6005
- Fax
- (208) 381-6006
- NPI assigned
- Apr 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M-16773 | ID | Primary |
| Psychiatry Physician | 2084P0800X | 10964340-1205 | UT |
Addresses
Primary practice location
403 S 11TH St Ste 210
Boise, ID 83702-6968
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
501 Chipeta Way
Rm. 1885
Salt Lake City, UT 84108
Phone (801) 581-4096
Other practice location 2
1500 Red River St
Austin, TX 78701-1918
Phone (512) 324-7000
Other practice location 3
703 S Americana Blvd Ste 150
Boise, ID 83702-4976
Phone (208) 706-6375
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221202001847 | ID | Practitioner - Psychiatry | 3971856246 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Texas Tech University Health Science Center School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Lukes Clinic-Treasure Valley LLC
Practice addresses (Care Compare)
100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384
403 S 11TH St
Boise, ID 83702-6968
520 S Eagle Rd
Meridian, ID 83642-6351
600 N Robbins Rd
Boise, ID 83702-4565
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711
9850 St Lukes Dr
Nampa, ID 83687-7912
9850 W St Luke'S Dr
Nampa, ID 83687-7912
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Lukes Magic Valley Medical Center
- St Luke'S Nampa Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-16773 | ID | MD | Psychiatry Physician |
| 10964340-1205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients |
Locations
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
703 S Americana Blvd
Ste 150
Boise, ID 83702
Phone (208) 706-6375
403 S 11th St
Ste 210
Boise, ID 83702
Phone (208) 381-6005
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
-
- Rural Health Clinic/Center
- Baker City, OR
- NPI 1336442607
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Twin Falls, ID
- NPI 1932154705
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1831621333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 S 11TH ST STE 210",
"city": "BOISE",
"state": "ID",
"postal_code": "837026968",
"telephone_number": "208-381-6005",
"fax_number": "208-381-6006"
}
],
"practiceLocations": [
{
"address_1": "501 Chipeta Way",
"address_2": "Rm. 1885",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "84108",
"country_code": "US",
"telephone_number": "801-581-4096",
"fax_number": "801-581-5604",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 Red River St",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787011918",
"country_code": "US",
"telephone_number": "512-324-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "703 S Americana Blvd Ste 150",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837024976",
"country_code": "US",
"telephone_number": "208-706-6375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE RIESE",
"first_name": "HEIKO",
"middle_name": "WEERT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-03",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M-16773",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "10964340-1205",
"primary": false
}
],
"identifiers": [],
"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 Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.