Active NPI
Tom Faciszewski, MD
- Orthopaedic Surgery Physician
- Boise, ID
National Provider Identifier
1992817167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- M-12458
- Practice address
- 4850 N Rosepoint Way
Suite 100
Boise, ID 83713-5262 - Phone
- (208) 475-0899
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | M-12458 | ID | Primary |
Addresses
Primary practice location
4850 N Rosepoint Way
Suite 100
Boise, ID 83713-5262
Mailing address
4850 N Rosepoint Way
Suite 100
Boise, ID 83713-5262
Phone (208) 475-0899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31890900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-12458 | ID | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488931200000",
"number": "1992817167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 N ROSEPOINT WAY",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837135262",
"telephone_number": "208-475-0899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 N ROSEPOINT WAY",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837135262",
"telephone_number": "208-475-0899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FACISZEWSKI",
"first_name": "TOM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2017-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "ID",
"license": "M-12458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31890900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}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 Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.