1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Specialist
  6. NPI Profile

GLEN S LOVELACE MD PA
NPI 1023053204
Specialist in Boise, ID

Active since June 19, 2006
333 N 1ST ST STE 260, BOISE, ID 83702(208) 345-3136(208) 345-0984 Get Directions Write a Review

NPPES record last updated: June 1, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Glen S Lovelace Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLEN S LOVELACE MD PA (NPI 1023053204) is a healthcare organization registered as a specialist in Boise, Idaho and active in the NPI registry since June 2006. The organization lists Glen S Lovelace, Owner, as its authorized official.

NPPES Registry Identity

NPI1023053204
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameGLEN S LOVELACE MD PA
Location Address333 N 1ST ST STE 260Boise, ID 83702-6132
Mailing Address333 N 1st St Ste 260Boise, ID 83702-6132 · (208) 345-3136 · Fax (208) 345-0984
Phone(208) 345-3136
Fax(208) 345-0984
Organization SubpartNo
Authorized OfficialGlen S LovelaceOwner · (208) 345-3136
Enumeration DateJune 19, 2006
Last NPPES UpdateJune 1, 2009
✔ NPI 1023053204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in ID · M6570
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
333 N 1ST ST STE 260, Boise, ID 83702
Open in Google Maps ↗

Other Identifiers 3

Other000010028711ID · Blue Shield Group Number
Other8D608ID · Blue Cross Group Number
Medicare ID-Type Unspecified1377264ID · Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glen S Lovelace Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Glen S Lovelace MD PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Megan Kitterman, CNM
Certified Nurse Midwife (CNM)
NPI 1013412402
333 N 1ST ST STE 260
Boise, ID 83702
(208) 345-3136
✔ PECOS✔ Accepts MedicareSame address
Angela Latta, NP-C
Nurse Practitioner
NPI 1346687654
333 N 1ST ST STE 260
Boise, ID 83702
(208) 345-3136
✔ PECOS✔ Accepts MedicareSame address
Glen Lovelace, MD
Obstetrics/Gynecology
NPI 1720023930
333 N 1ST ST STE 260
Boise, ID 83702
(208) 345-3136
✔ PECOS✔ Accepts MedicareSame address
Kristina Rhodes, CNM
Certified Nurse Midwife (CNM)
NPI 1417389222
333 N 1ST ST STE 260
Boise, ID 83702
(208) 345-3136
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen S Lovelace MD PA's NPI number?

The NPI number for Glen S Lovelace MD PA is 1023053204. It was assigned to this organization in the NPPES registry on June 19, 2006.

Where is Glen S Lovelace MD PA located?

Glen S Lovelace MD PA is located at 333 N 1st St Ste 260, Boise, ID 83702. The listed phone number is (208) 345-3136.

What is Glen S Lovelace MD PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Glen S Lovelace MD PA enrolled in Medicare?

Yes. Glen S Lovelace MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Glen S Lovelace MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Glen S Lovelace MD PA, in Certified Nurse Midwife (CNM), Nurse Practitioner and Obstetrics/Gynecology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Glen S Lovelace MD PA accept?

Health plans from Moda Health Plan, Inc. list Glen S Lovelace MD PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glen S Lovelace MD PA was last updated on June 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.