Ralene Wiberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-12117 Issued in ID

Practice address

211 16TH Ave N
Nampa, ID 83687-4058

Phone

(208) 461-7149

Fax

(208) 467-3391

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, HI2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Hospice - Hawaii, LLC Hospice, Honolulu, HI, CCN 121508
• Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Idaho- Nampa PLLC

  • Emergency Medicine Physician
  • Lewiston, ID
  • NPI 1558995316
  Medicare reassignment NPD
• Sound Physicians of Idaho

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461

  Family Medicine

  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bristol Hospice - Hawaii, LLC

  • Community Based Hospice Care Agency
  • Honolulu, HI
  • NPI 1811045594
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1396813861
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1912956806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 16TH AVE N",
            "address_2": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836874058",
            "telephone_number": "208-461-7149",
            "fax_number": "208-467-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 16TH AVE N",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836874058",
            "telephone_number": "208-461-7149",
            "fax_number": "208-467-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBERG",
        "first_name": "RALENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "ID",
            "license": "NP464A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101252362",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-12117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "NP464A",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baylie Whiting, PA
• Rebecca Irene Whitmore
• Karen Meliza Whittaker, MS
• Whole Health Chiropractic, PA
• Whole Life Midwifery and Birth Center
• Amaisha Wiebe, M.S. CCC-SLP
• Ladonna Wiedenman, BS
• Joseph Gregory Wilbanks, MD
• Heather Ann Wilcke, NP-C
• Megan Peterson Wilde, DDS

• Family Medicine Physician in Nampa, ID
• Providers in Nampa, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.