Individual provider Active NPI

Dane Mosher

  • Family Medicine Physician
  • Hayden, ID
National Provider Identifier
1932398310
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1644 Issued in ID
Practice address
8880 N Hess St Unit 1
Hayden, ID 83835-8741
Phone
(208) 772-5204
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-1644 ID Primary

Addresses

Primary practice location

8880 N Hess St Unit 1
Hayden, ID 83835-8741

Mailing address

6848 N Government Way Ste 114
PMB 9
Dalton Gardens, ID 83815-7799
Phone (512) 222-3263

Other practice location 1

2238 N Government Way
Coeur d Alene, ID 83814
Phone (208) 254-1986

Other practice location 2

1700 Rio Grande St
Austin, TX 78701-1124
Phone (512) 732-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2023 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-1644IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho DPC, PLLC Family Medicine PastSince Oct 5, 2025 Accepting new patients
Emmaus Community Healthcare, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1932398310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6848 N GOVERNMENT WAY STE 114",
            "address_2": "PMB 9",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838157799",
            "telephone_number": "512-222-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 N HESS ST UNIT 1",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358741",
            "telephone_number": "208-772-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2238 N Government Way",
            "address_purpose": "LOCATION",
            "city": "Coeur d Alene",
            "state": "ID",
            "postal_code": "83814",
            "country_code": "US",
            "telephone_number": "208-254-1986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Rio Grande St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787011124",
            "country_code": "US",
            "telephone_number": "512-732-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "DANE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.