Individual provider Active NPI

Matthew M Bender, MD

  • Dermatology Physician
  • Garden City, ID
National Provider Identifier
1881633162
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M9026 Issued in ID
Practice address
5601 W Chinden Blvd
Garden City, ID 83714-1463
Phone
(208) 809-2865
Fax
(208) 947-1945
NPI assigned
Jun 5, 2006
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X M9026 ID Primary

Addresses

Primary practice location

5601 W Chinden Blvd
Garden City, ID 83714-1463

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
806939200MedicaidID

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722001326 ID Practitioner - DermatologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 5698755304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at San Antonio, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

6052 W State St
Boise, ID 83703-2739
Phone (208) 947-1947

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
77.29
Promoting interoperability
97
Improvement activities
40
Cost
74.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions340
Removal or shaving of skin growth1-10
Skin biopsy95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9026IDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC CurrentSince Jun 1, 2005 Accepting new patients
Alliance Medical Group, LLC Current Accepting new patients
Alliance Medical Group, LLC Past Accepting new patients

Locations

6052 W State St
Boise, ID 83703
Phone (208) 344-7799

8971 W Overland Rd
Boise, ID 83709
Phone (208) 378-4288

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

5601 W Chinden Blvd
Garden City, ID 83714
Phone (208) 809-2865

Interoperability endpoints

  • Direct secure messaging: matthew.bender@phmg.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1881633162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W CHINDEN BLVD",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141463",
            "telephone_number": "208-809-2865",
            "fax_number": "208-947-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M9026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806939200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, ID

Sources for this page

Verify at the official NPI Registry.