DERMATOLOGY CLINIC OF IDAHO
NPI 1548758501
Dermatology in Boise, ID
About Dermatology Clinic Of Idaho NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERMATOLOGY CLINIC OF IDAHO (NPI 1548758501) is a healthcare organization registered as a dermatology in Boise, Idaho and active in the NPI registry since April 2018. The organization holds a CLIA Certificate of Compliance certificate valid through December 4, 2026 and lists Bret S Blackhart, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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)
Dermatology Clinic Of Idaho is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
20Medicare enrollment records show 20 clinicians reassign Medicare billing to Dermatology Clinic Of Idaho, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (20)
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 Compliance 13D0521865
Dermatology Clinic Of Idaho · 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 Mountain West Derm-Blackhart, PLLC's NPI number?
The NPI number for Mountain West Derm-Blackhart, PLLC is 1548758501. It was assigned to this organization in the NPPES registry on April 25, 2018. The provider is doing business as Dermatology Clinic Of Idaho.
Where is Mountain West Derm-Blackhart, PLLC located?
Mountain West Derm-Blackhart, PLLC is located at 7733 W Emerald St, Boise, ID 83704. The listed phone number is (208) 939-4599.
What is Mountain West Derm-Blackhart, PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Mountain West Derm-Blackhart, PLLC enrolled in Medicare?
Yes. Mountain West Derm-Blackhart, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mountain West Derm-Blackhart, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 20 clinicians in 4 Medicare specialties reassign their Medicare billing to Mountain West Derm-Blackhart, 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. The largest specialties are Dermatology (14), Nurse Practitioner (4) and Emergency Medicine (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mountain West Derm-Blackhart, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 13D0521865) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mountain West Derm-Blackhart, PLLC accept?
Health plans from Molina Healthcare list Mountain West Derm-Blackhart, 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 Mountain West Derm-Blackhart, PLLC was last updated on April 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.