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COMPREHENSIVE DERMATOLOGY OF IDAHO, PLLC
NPI 1386921294
Dermatology in Nampa, ID

Active since November 05, 2011CLIA 13D2033645 · Microscopy
16111 N BRINSON ST STE 100, NAMPA, ID 83687(208) 467-7546(208) 467-7500 Get Directions Write a Review

NPPES record last updated: December 23, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Comprehensive Dermatology Of Idaho, Pllc NPPES

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

COMPREHENSIVE DERMATOLOGY OF IDAHO, PLLC (NPI 1386921294) is a healthcare organization registered as a dermatology in Nampa, Idaho and active in the NPI registry since November 2011. The organization holds a CLIA Microscopy certificate valid through December 6, 2027 and lists Ryan Scott Owsley, Owner, as its authorized official.

NPPES Registry Identity

NPI1386921294
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCOMPREHENSIVE DERMATOLOGY OF IDAHO, PLLC
Location Address16111 N BRINSON ST STE 100Nampa, ID 83687-5509
Mailing Address16111 N Brinson St Ste 100Nampa, ID 83687-5509 · (208) 467-7546 · Fax (208) 467-7500
Phone(208) 467-7546
Fax(208) 467-7500
Organization SubpartNo
Authorized OfficialRyan Scott OwsleyOwner · (208) 467-7546
Enumeration DateNovember 5, 2011
Last NPPES UpdateDecember 23, 2019
✔ NPI 1386921294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in ID · M8483
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA280 (ID)
16111 N BRINSON ST STE 100, Nampa, ID 83687
Open in Google Maps ↗

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Comprehensive Dermatology Of Idaho, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIdahoEnrollment IDO20120310000063Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Comprehensive Dermatology Of Idaho, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ryan Owsley, MD
Dermatology
NPI 1659361681
16111 N BRINSON ST STE 100
Nampa, ID 83687
(208) 467-7546
✔ 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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D2033645

Comprehensive Dermatology Of Idaho PLLC · Nampa, ID
Active · expires Dec 6, 2027
CLIA Number13D2033645
Laboratory TypePhysician Office
Certificate Effective DateDecember 7, 2025
Certificate Expiration DateDecember 6, 2027
Laboratory DirectorRyan S. Owsley
Laboratory Phone(208) 467-7546
Laboratory LocationComprehensive Dermatology Of Idaho PLLC16111 N Brinson St Ste 100, Nampa, ID 83687
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Comprehensive Dermatology Of Idaho, PLLC's NPI number?

The NPI number for Comprehensive Dermatology Of Idaho, PLLC is 1386921294. It was assigned to this organization in the NPPES registry on November 5, 2011.

Where is Comprehensive Dermatology Of Idaho, PLLC located?

Comprehensive Dermatology Of Idaho, PLLC is located at 16111 N Brinson St Ste 100, Nampa, ID 83687. The listed phone number is (208) 467-7546.

What is Comprehensive Dermatology Of Idaho, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Comprehensive Dermatology Of Idaho, PLLC enrolled in Medicare?

Yes. Comprehensive Dermatology Of Idaho, PLLC is registered in the Medicare PECOS enrollment system.

When is Comprehensive Dermatology Of Idaho, PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Comprehensive Dermatology Of Idaho, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Comprehensive Dermatology Of Idaho, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Comprehensive Dermatology Of Idaho, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D2033645) is associated with this NPI, valid through December 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Comprehensive Dermatology Of Idaho, PLLC accept?

Health plans from Moda Health Plan, Inc. list Comprehensive Dermatology Of Idaho, PLLC 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 Comprehensive Dermatology Of Idaho, PLLC was last updated on December 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.