NPIMap

Alliance Medical Group, LLC

Organization Active NPI Family Medicine Physician · Boise, ID

NPI 1871969246 · NPPES record last updated Feb 17, 2025

Key facts

NPI
1871969246
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ALLIANCE MEDICAL GROUP, LLC
Practice address
4971 W. Overland Road
Boise, ID 83705
Phone
(208) 472-5050
Fax
(208) 472-5051
NPI assigned
Aug 19, 2015
Organization subpart
No

Authorized official

Name
Linda Barnes
Title
Credentialing MGR
Phone
(208) 985-1423

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 132

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

View all 132

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2102904Primary Health Medical Group - Orchard
4971 W Overland Rd, Boise, ID 83705		Provider-performed microscopySep 30, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151103000690 ID DME Supplier - Physician - General Practice 3971544685 1 other NPI on this enrollment
Practice locations: Boise, ID

National Provider Directory

Tax ID family
Alliance Medical Group LLC (17 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

4971 W. Overland Road
Boise, ID 83705

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Other names

  • Primary Health Medical Group Doing business as

Other providers in Boise, ID

All providers in Boise, ID · Family Medicine Physician in Idaho

Sources for this page

Verify at the official NPI Registry.