Individual provider Active NPI

Grace Mensah, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boise, ID
National Provider Identifier
1932988680
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
59058 Issued in ID
Practice address
5985 W State St
Boise, ID 83703-3039
Phone
(208) 853-0071
NPI assigned
Sep 22, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 59058 ID Primary

Addresses

Primary practice location

5985 W State St
Boise, ID 83703-3039

Mailing address

4052 E Esperanto St
Meridian, ID 83642-5424
Phone (208) 936-1692

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
I20240201002447 ID Practitioner - Nurse Practitioner 9739532110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dwyer and Harrington, PLLCGroup PAC ID 4981838711, 12 clinicians

Practice addresses (Care Compare)

5985 W State St
Boise, ID 83703-3039
Phone (208) 853-0071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
59058IDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dwyer & Harrington, PLLC CurrentSince Nov 18, 2023 Accepting new patients

Locations

5985 W State St
Boise, ID 83703
Phone (208) 853-0071

7235 W Emerald St
Ste C
Boise, ID 83704

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, 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": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1932988680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 E ESPERANTO ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425424",
            "telephone_number": "208-936-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5985 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-853-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSAH",
        "first_name": "GRACE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "59058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.