TARA MARIE DAVIDSON MD
NPI 1164085452
Internal Medicine in Boise, ID
About Tara Marie Davidson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TARA MARIE DAVIDSON MD (NPI 1164085452) is an individual internal medicine provider in Boise, Idaho, licensed in Texas (U2470) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tara Marie Davidson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Tara Davidson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Boise, ID 83712
- Reassigned Medicare billing, Idaho enrollment
- 1,312 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Lukes Magic Valley Medical Center
Acute Care Hospitals · Twin Falls, IDSt Luke's Regional Medical Center
Acute Care Hospitals · Boise, IDSt Luke's Elmore Medical Center
Critical Access Hospitals · Mountain Home, IDSt Luke's Mccall
Critical Access Hospitals · Mccall, IDSt Luke's Wood River Medical Center
Critical Access Hospitals · Ketchum, IDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83712 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BOISE, ID 83712
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 Tara Davidson's NPI number?
The NPI number for Tara Davidson is 1164085452. It was assigned to this individual provider in the NPPES registry on April 22, 2019.
Where is Tara Davidson located?
Tara Davidson practices at 100 E Idaho St, Boise, ID 83712. The listed phone number is (208) 381-2711.
What is Tara Davidson's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Tara Davidson enrolled in Medicare?
Yes. Tara Davidson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tara Davidson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tara Davidson reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Boise, ID). The 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 Tara Davidson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tara Davidson accept?
Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Select Health list Tara Davidson 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.
Is Tara Davidson affiliated with any hospitals?
According to CMS data, Tara Davidson is affiliated with St Lukes Magic Valley Medical Center, St Luke's Regional Medical Center, St Luke's Elmore Medical Center, St Luke's Mccall and St Luke's Wood River Medical Center.
When was this NPI record last updated?
The NPPES record for Tara Davidson was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Tara Marie Davidson, MD · NPI 1164085452
Internal Medicine physician in Boise, Idaho. Individual provider, active in the CMS NPPES registry since April 22, 2019.
## Identity
- **NPI:** 1164085452 (Entity type: Individual)
- **Enumerated:** April 22, 2019
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** U2470 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 E IDAHO ST, Boise, ID 83712-6267
- **Phone:** (208) 381-2711 · **Fax:** (208) 381-4025
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Lukes Clinic-Treasure Valley LLC (NPI 1326336058, Boise, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164085452) · Data from the CMS NPPES public registry.