MOMENTUM MEDICAL GROUP OF IDAHO LLC
NPI 1417737594
Family Medicine in Boise, ID
About Momentum Medical Group Of Idaho Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOMENTUM MEDICAL GROUP OF IDAHO LLC (NPI 1417737594) is a healthcare organization registered as a family medicine in Boise, Idaho and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through December 3, 2027 and lists Heather Beard, Billing Service, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted 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)
Momentum Medical Group Of Idaho Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Momentum Medical Group Of Idaho LLC, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 of Waiver 13D2294962
Momentum Medical Group Of Idaho LLC · Boise, IDFrequently 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 Momentum Medical Group Of Idaho LLC's NPI number?
The NPI number for Momentum Medical Group Of Idaho LLC is 1417737594. It was assigned to this organization in the NPPES registry on October 4, 2023.
Where is Momentum Medical Group Of Idaho LLC located?
Momentum Medical Group Of Idaho LLC is located at 8854 W Emerald St Ste 275, Boise, ID 83704. The listed phone number is (208) 375-3201.
What is Momentum Medical Group Of Idaho LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Momentum Medical Group Of Idaho LLC enrolled in Medicare?
Yes. Momentum Medical Group Of Idaho LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Momentum Medical Group Of Idaho LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Momentum Medical Group Of Idaho LLC. 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. The largest specialties are Family Practice (3), Internal Medicine (1) and Nurse Practitioner (1). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Momentum Medical Group Of Idaho LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2294962) is associated with this NPI, valid through December 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Momentum Medical Group Of Idaho LLC accept?
Health plans from Moda Health Plan, Inc. list Momentum Medical Group Of Idaho LLC 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 Momentum Medical Group Of Idaho LLC was last updated on January 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Momentum Medical Group Of Idaho Llc · NPI 1417737594
Family Medicine organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since October 4, 2023.
## Identity
- **NPI:** 1417737594 (Entity type: Organization)
- **Enumerated:** October 4, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Heather Beard, BILLING SERVICE
## Practice location
- **Address:** 8854 W EMERALD ST STE 275, Boise, ID 83704-4860
- **Phone:** (208) 375-3201
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (3), Internal Medicine (1), Nurse Practitioner (1); 4 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 10, 2024
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1417737594) · Data from the CMS NPPES public registry.