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

Q: 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.

Q: What is Mmmedical Group LLC.'s specialty?

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

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: October 25, 2026.

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

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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

Phone(208) 332-4540

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

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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

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Molina Healthcare.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)

Mmmedical Group Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 5 clinicians reassign Medicare billing to Mmmedical Group LLC., 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, nearest first (5)

Kara Delacy, FNP

Nurse Practitioner

NPI 1942485180

801 N STILSON RD STE 300
Boise, ID 83703

(208) 332-4540

✔ PECOS✔ Accepts MedicareSame address

Mary Driscoll, DNP

Nurse Practitioner

NPI 1922966951

801 N STILSON RD STE 100
Boise, ID 83703

(208) 332-4540

✔ PECOS✔ Accepts Medicare0.1 mi

Eric Donahue

Hospitalist

NPI 1831624691

9850 W ST LUKES DR
Nampa, ID 83687

(208) 205-7282

✔ PECOS✔ Accepts Medicare18 mi

Bobbi Fuller, DNP

Nurse Practitioner

NPI 1730798695

709 S. WASHINGTON AVE SUITE B
Emmett, ID 83617

(208) 740-8808

✔ PECOS✔ Accepts Medicare21 mi

Laura Thompson, FNP

Nurse Practitioner

NPI 1518709898

640 SW 4TH AVE
Ontario, OR 97914

(888) 875-7820

✔ PECOS✔ Accepts Medicare45 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Is Mmmedical Group LLC. enrolled in Medicare?

Yes. Mmmedical Group LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mmmedical Group LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Mmmedical Group 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 Nurse Practitioner (4) and Hospitalist (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.

What insurance does Mmmedical Group LLC. accept?

Health plans from Moda Health Plan, Inc. and Molina Healthcare 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 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.