Irene Pucciarelli, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

O0633 Issued in ID

Practice address

701 E Parkcenter Blvd
Boise, ID 83706-6528

Phone

(208) 381-6400

Fax

(208) 381-6450

NPI assigned

Apr 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ipucciarelli9072@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Internal Medicine

  NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1447299342
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)
• Spirit Physician Services Inc.

  • Diagnostic Radiology Physician
  • Camp Hill, PA
  • NPI 1275072662
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347667200000",
    "number": "1871559948",
    "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",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066528",
            "telephone_number": "208-381-6400",
            "fax_number": "208-381-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIARELLI",
        "first_name": "IRENE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS012839",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O0633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noelle Graves Pruitt, DNP, MN, FNP-C
• Psychiatry 121 PLLC
• Psychology Services, PLLC
• Public Denture Center
• Public Health District IV
• Devin R Pugmire, PSS
• Jeffrey M Pugsley, MD
• Amy Suzanne Pullen, PHARM.D.
• Aubrey Pulsipher
• Jocelyn Breanne Pulver, LPC

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.