Individual provider Active NPI

Darryl D Barnes, PA

  • Medical Physician Assistant
  • Boise, ID
National Provider Identifier
1891733663
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA315 Issued in ID
Practice address
1907 S Broadway Ave # 101
Boise, ID 83706-4201
Phone
(208) 345-1222
Fax
(208) 345-1261
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA315 ID Primary

Addresses

Primary practice location

1907 S Broadway Ave # 101
Boise, ID 83706-4201

Mailing address

1907 S Broadway Ave # 101
Boise, ID 83706-4201
Phone (208) 345-1222

Other identifiers 1

IdentifierTypeStateIssuer
805863500MedicaidID

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000817 ID Practitioner - Physician Assistant 7810938396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA315IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Family Medicine Current Accepting new patients

Locations

1907 S Broadway Ave
Ste 101
Boise, ID 83706
Phone (208) 345-1222

512 N 21st Ave
Caldwell, ID 83605
Phone (208) 809-2875

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

Interoperability endpoints

  • Direct secure messaging: darryl.barnes@phmg.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1891733663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 S BROADWAY AVE # 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064201",
            "telephone_number": "208-345-1222",
            "fax_number": "208-345-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S BROADWAY AVE # 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064201",
            "telephone_number": "208-345-1222",
            "fax_number": "208-345-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "DARRYL",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805863500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.