Boise Surgical Group

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M7481 Issued in ID

Legal business name

BOISE SURGICAL GROUP

Practice address

3399 E. Louise Dr.
#400
Meridian, ID 83642

Phone

(208) 364-3000

Fax

(208) 364-3191

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Kirsten Grunzke

Title

Practice Administrator

Phone

(208) 364-3000

Specialties & licenses 4

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roberto V. Barresi, MD

  • Surgery Physician
  • Meridian, ID
  • NPI 1740231620
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1871648352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 E. LOUISE DR.",
            "address_2": "#400",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-364-3000",
            "fax_number": "208-364-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 E. LOUISE DR.",
            "address_2": "#400",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-364-3000",
            "fax_number": "208-364-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE SURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "GRUNZKE",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "208-364-3000"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "M7481",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "M8489",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "M7975",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "M8195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI1633",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002354900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boise Imaging Solutions LLC
• Boise Intensive Care Hospital Inc
• Boise Intensive Care Hospital, Inc.
• Boise Kidney & Hypertension PLLC
• Boise Naturopathic Medicine PC
• Boise Valley Anesthesia LLC
• Michelle Louise Boisvert, PT
• Michelle Boling, MS, BCBA
• Eva Crucillo Bolivar-Guth
• Brian Bollwitt, D.M.D.

• Surgery Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.