MMMEDICAL GROUP LLC.
NPI 1548890460
Nurse Practitioner in Boise, ID

Active since January 20, 2020
801 N STILSON RD STE 300, BOISE, ID 83703(208) 332-4540 Get Directions Write a Review

NPPES record last updated: September 23, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 23, 2020, Jul 27, 2020, Jan 20, 2020 (3 updates tracked since 2020).

About Mmmedical Group Llc. NPPES

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

MMMEDICAL GROUP LLC. (NPI 1548890460) is a healthcare organization registered as a nurse practitioner in Boise, Idaho and active in the NPI registry since January 2020. The organization maintains a secondary practice location in Star and lists Randy Evaro, President, as its authorized official.

NPPES Registry Identity

NPI1548890460
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameMMMEDICAL GROUP LLC.
Location Address801 N STILSON RD STE 300Boise, ID 83703-5145
Mailing AddressPo Box 5328Boise, ID 83705-0328 · (208) 333-0000
Organization SubpartNo
Authorized OfficialRandy EvaroPresident · (208) 333-0000
Enumeration DateJanuary 20, 2020
Last NPPES UpdateSeptember 23, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2020
NPI 1548890460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
801 N STILSON RD STE 300, Boise, ID 83703

Secondary Practice Location 1

Location 19858 W State StStar, ID 83669-5210 · Phone (208) 286-9471 · Fax (833) 918-0940

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
801 N STILSON RD STE 300
BOISE, ID 83703

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 Mmmedical Group LLC.'s NPI number?

The NPI number for Mmmedical Group LLC. is 1548890460. It was assigned to this organization in the NPPES registry on January 20, 2020.

Where is Mmmedical Group LLC. located?

Mmmedical Group LLC. is located at 801 N Stilson Rd Ste 300, Boise, ID 83703. The listed phone number is (208) 332-4540.

What is Mmmedical Group LLC.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

What insurance does Mmmedical Group LLC. accept?

Health plans from Moda Health Plan, Inc. list Mmmedical Group 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 Mmmedical Group LLC. was last updated on September 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.