Daniel R Marshall, DO

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

O-0508 Issued in ID

Practice address

393 E 2ND N
Rexburg, ID 83440-1605

Phone

(208) 359-4841

Fax

(208) 359-4842

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alpine Dermatology Clinic P.C.Group PAC ID 5698827640, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

35.17 of 100Reported as individual

Quality

36.67

Promoting interoperability

0

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Alpine Dermatology Clinic P.C.

  • Medical Specialty Clinic/Center
  • Rexburg, ID
  • NPI 1588802391
  Medicare reassignment Care Compare group NPD Authorized official
• Emcare Physician Providers, Inc.

  • Emergency Medicine Physician
  • Kirksville, MO
  • NPI 1437109527
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1861583486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-4841",
            "fax_number": "208-359-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-4841",
            "fax_number": "208-359-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2006018423",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "O-0508",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "O-0508",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808295400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Talon Gervis Mansfield
• Alice Dawn Manwaring, LCSW
• Neil Marion
• Roy H. Marlowe, PH.D.
• Emily Morgan Marriott
• Matthew Scott Matson, PT, DPT
• Spencer E. Mauseth, D.D.S.
• Max Hansen Surgery PLLC
• Kurt R Mayberry, MD
• James McCoy, MD

• MOHS-Micrographic Surgery Physician in Rexburg, ID
• Providers in Rexburg, ID by specialty
• MOHS-Micrographic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.

Verify at the official NPI Registry.