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ST MIKES NEPH
NPI 1144887050
Internal Medicine - Nephrology in Boise, ID

Active since May 26, 2019
1674 S LOGGERS POND PL APT 14, BOISE, ID 83706(986) 200-8202(626) 593-4751 Get Directions Write a Review

NPPES record last updated: July 14, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 14, 2019, May 26, 2019 (2 updates tracked since 2019).

About St Mikes Neph NPPES

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

ST MIKES NEPH (NPI 1144887050) is a healthcare organization registered as a nephrology in Boise, Idaho and active in the NPI registry since May 2019. The organization maintains a secondary practice location in Boise and lists Ernest Daniel Moreno Dytiapco, Nephrologist, as its authorized official.

NPPES Registry Identity

NPI1144887050
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameST MICHAEL NEPHROLOGY, PLLC
Location Address1674 S LOGGERS POND PL APT 14Boise, ID 83706-7517
Mailing Address999 W Main St Ste 100Boise, ID 83702-9001
Phone(986) 200-8202
Fax(626) 593-4751
Organization SubpartNo
Authorized OfficialErnest Daniel Moreno DytiapcoNephrologist · (986) 200-8202
Enumeration DateMay 26, 2019
Last NPPES UpdateJuly 14, 20192 updates tracked since enumeration
✔ NPI 1144887050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1674 S LOGGERS POND PL APT 14, Boise, ID 83706
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Other Names 1

Doing Business AsSt Mikes Neph

Secondary Practice Location 1

Location 1190 E Bannock StBoise, ID 83712 · Phone (986) 200-8202

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

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 St Michael Nephrology, PLLC's NPI number?

The NPI number for St Michael Nephrology, PLLC is 1144887050. It was assigned to this organization in the NPPES registry on May 26, 2019. The provider is doing business as St Mikes Neph.

Where is St Michael Nephrology, PLLC located?

St Michael Nephrology, PLLC is located at 1674 S Loggers Pond Pl Apt 14, Boise, ID 83706. The listed phone number is (986) 200-8202.

What is St Michael Nephrology, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

When was this NPI record last updated?

The NPPES record for St Michael Nephrology, PLLC was last updated on July 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.