NPIMap

Individual provider Active NPI

Daniel KP Noonan, MD

  • Clinical Cardiac Electrophysiology Physician
  • Boise, ID
National Provider Identifier
1942474853
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
M-12094 Issued in ID
Practice address
287 W Jefferson St
Boise, ID 83702-6045
Phone
(208) 322-1680
NPI assigned
Apr 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M-12094 ID
Clinical Cardiac Electrophysiology Physician 207RC0001X M-12094 ID Primary

Addresses

Primary practice location

287 W Jefferson St
Boise, ID 83702-6045

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

Other identifiers 1

IdentifierTypeStateIssuer
1942474853MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131015000198 ID Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 8224262886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Missouri, Kansas City, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Heart and VascularGroup PAC ID 7113389909, 10 clinicians

Practice addresses (Care Compare)

3015 E Goldstone Dr
Suite 230
Meridian, ID 83642-1224
Phone (208) 781-6039

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-12094IDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Cardiovascular Disease CurrentSince Jul 31, 2013 Accepting new patients
High Desert Heart & Vascular Cardiovascular Disease CurrentSince Jul 1, 2023 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

8854 W Emerald St
Ste 260
Boise, ID 83704
Phone (208) 398-4306

287 W Jefferson St
Boise, ID 83702
Phone (208) 343-7940

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

3015 E Goldstone Dr
Ste 230
Meridian, ID 83642
Phone (208) 398-4306

Interoperability endpoints

  • Direct secure messaging: daniel.noonan.p47@direct.newportmed.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: daniel.noonan.p47@direct.hdhv.nextgenshare.com

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1942474853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 W JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026045",
            "telephone_number": "208-322-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "DANIEL",
        "middle_name": "KP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-12094",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "ID",
            "license": "M-12094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942474853",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.