Active NPI
Mary Kathleen Migliori, MD
- Anesthesiology Physician
- Boise, ID
National Provider Identifier
1972545960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- M6290
- Practice address
- 8800 W Emerald St
Boise, ID 83704-8205 - Phone
- (208) 373-5000
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | M6290 | ID | Primary |
Addresses
Primary practice location
8800 W Emerald St
Boise, ID 83704-8205
Mailing address
PO Box 4008
Portland, OR 97208-4008
Phone (503) 372-2740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287543 | Medicaid | OR |
Other names 1
- Mary Kathleen Benavides
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
- Opted out of Medicare
- Yes, effective Dec 13, 2016 through Dec 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6290 | ID | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Consultants of Treasure Valley PLLC | Anesthesiology | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Boise, ID
- NPI 1124066063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1972545960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4008",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084008",
"telephone_number": "503-372-2740",
"fax_number": "503-372-2754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8800 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837048205",
"telephone_number": "208-373-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIGLIORI",
"first_name": "MARY",
"middle_name": "KATHLEEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ID",
"license": "M6290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "287543",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "BENAVIDES",
"middle_name": "KATHLEEN",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.