NPIMap

Individual provider Active NPI

Michael W Foutz, MD

  • Family Medicine Physician
  • Kuna, ID
National Provider Identifier
1992782361
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M8658 Issued in ID
Practice address
943 Linder Rd
Suite 103
Kuna, ID 83634-3394
Phone
(208) 922-3355
Fax
(208) 922-9499
NPI assigned
Dec 28, 2005
Last updated
Nov 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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 M8658 ID Primary

Addresses

Primary practice location

943 Linder Rd
Suite 103
Kuna, ID 83634-3394

Mailing address

943 Linder Rd
Suite 103
Kuna, ID 83634-3394
Phone (208) 922-3355

Other identifiers 1

IdentifierTypeStateIssuer
806958500MedicaidID

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
I20041027001271 ID Practitioner - Family Practice 5698737120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Family Medicine PLLCGroup PAC ID 2264494798, 5 clinicians

Practice addresses (Care Compare)

943 N Linder Rd
Suite 103
Kuna, ID 83634-3395
Phone (208) 922-3355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8658IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kuna Healthcare Clinic, PLLC CurrentSince Mar 4, 2019 Accepting new patients
Advanced Family Medicine PLLC Family Medicine CurrentSince Jul 6, 2004 Accepting new patients
Physical Therapy Centers of Idaho PastSince Sep 12, 2016 Accepting new patients
Jones Foot & Ankle LLC Past Accepting new patients

Locations

8854 W Emerald St
Ste 280
Boise, ID 83704
Phone (208) 377-5005

825 W Deer Flat Rd
#150
Kuna, ID 83634
Phone (208) 404-2262

943 N Linder Rd
#103
Kuna, ID 83634
Phone (208) 922-3355

943 N Linder Rd
Ste 103
Kuna, ID 83634
Phone (208) 565-0978

Organizations & group practices 4

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 10

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1992782361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 LINDER RD",
            "address_2": "SUITE 103",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343394",
            "telephone_number": "208-922-3355",
            "fax_number": "208-922-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 LINDER RD",
            "address_2": "SUITE 103",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343394",
            "telephone_number": "208-922-3355",
            "fax_number": "208-922-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTZ",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M8658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806958500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kuna, ID

Sources for this page

Verify at the official NPI Registry.