SANDY LEIGH MUDGE MD, MPH
NPI 1366704017
Family Medicine in Boise, ID

Q: What is Sandy Mudge's NPI number?

The NPI number for Sandy Mudge is 1366704017. It was assigned to this individual provider in the NPPES registry on June 8, 2012.

Q: What is Sandy Mudge's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sandy Mudge was last updated on September 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 08, 2012PECOS EnrolledAccepts Medicare Assignment

777 N RAYMOND ST, BOISE, ID 83704(208) 514-2500(208) 375-2217 Get Directions Write a Review

NPPES record last updated: September 25, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sandy Leigh Mudge Md, Mph NPPES

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

SANDY LEIGH MUDGE MD, MPH (NPI 1366704017) is an individual family medicine provider in Boise, Idaho, licensed in Idaho (M-12212) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Tulane University School Of Medicine (2012).

NPPES Registry Identity

NPI1366704017

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSANDY LEIGH MUDGECredential: MD, MPH

Location Address777 N RAYMOND STBoise, ID 83704-9251

Mailing Address777 N Raymond StBoise, ID 83704-9251 · (208) 514-2500 · Fax (208) 375-2217

Phone(208) 514-2500

Fax(208) 375-2217

Sole ProprietorNo

Medical School CMSTulane University School Of MedicineGraduated 2012

Enumeration DateJune 8, 2012

Last NPPES UpdateSeptember 25, 2015

✔ NPI 1366704017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ID · M-12212✔ Licensed in ID · MRM-1258

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

777 N RAYMOND ST, Boise, ID 83704

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Other Identifiers 6

Medicare PIN20007326ID

Medicaid1366704017ID

Medicare PIN20007334ID

Medicare PIN20007324ID

Medicare PIN20007333ID

Medicare PIN20007325ID

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sandy Leigh Mudge Md, Mph 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.

PECOS PAC ID8224268164

PECOS Enrollment IDI20150818004653

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

TRACY ADAMS DO

Family Medicine