NPIMap

Individual provider Active NPI

Zachary Charles Yenna, M.D.

  • Orthopaedic Surgery Physician
  • Meridian, ID
National Provider Identifier
1992062566
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M-16032 Issued in ID
Practice address
3399 E Louise Dr Ste 200
Meridian, ID 83642-5212
Phone
(208) 706-2663
NPI assigned
Apr 19, 2012
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35.131519 OH
Orthopaedic Surgery Physician 207X00000X M-16032 ID Primary

Addresses

Primary practice location

3399 E Louise Dr Ste 200
Meridian, ID 83642-5212

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180702001285 UT Practitioner - Orthopedic Surgery 0345558961 Reassigns benefits to 1 organization
I20220307001253 ID Practitioner - Orthopedic Surgery 0345558961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Louisville School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

3399 E Louise Dr
Suite 200
Meridian, ID 83642-5047
Phone (208) 706-2663

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement41
Knee replacement68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16032IDMDOrthopaedic Surgery Physician
R3132KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Dec 1, 2021 Accepting new patients
Physician Group of Utah Inc CurrentSince Aug 1, 2018 Accepting new patients
St Lukes Regional Medical Center PastSince Dec 1, 2021 Accepting new patients

Locations

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

2619 W Fairview Ave
Fl 2
Boise, ID 83702

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

3399 E Louise Dr
Ste 200
Meridian, ID 83642

2132 N Robins Dr
Layton, UT 84041
Phone (801) 728-0600

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1992062566",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 E LOUISE DR STE 200",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425212",
            "telephone_number": "208-706-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENNA",
        "first_name": "ZACHARY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.131519",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-16032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.