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MARY K DERLACKI FNP
NPI 1609947431
Internal Medicine - Rheumatology in Boise, ID

Active since November 13, 2006PECOS Enrolled
2800 W OVERLAND RD, BOISE, ID 83705(208) 801-1414(208) 207-2866 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary K Derlacki Fnp NPPES

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

MARY K DERLACKI FNP (NPI 1609947431) is an individual rheumatology provider in Boise, Idaho, licensed in Oregon (090006104N1) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609947431
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameMARY K DERLACKICredential: FNP
Location Address2800 W OVERLAND RDBoise, ID 83705-3038
Mailing Address1707 N 19th StBoise, ID 83702-0706 · (541) 232-6732
Phone(208) 801-1414
Fax(208) 207-2866
Sole ProprietorNo
Enumeration DateNovember 13, 2006
Last NPPES UpdateOctober 17, 2024
NPPES CertifiedOctober 17, 2024
✔ NPI 1609947431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in OR · 090006104N1
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 69483 (ID)
2800 W OVERLAND RD, Boise, ID 83705
Open in Google Maps ↗

Other Identifiers 1

Medicaid005785OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary K Derlacki Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.27 typical visit price
range $52.44 – $160.17
Typical copayment $30.31 (range $13.11 – $40.04)
Most-billed visit code 99204
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

BOISE KETAMINE CLINIC
Clinic/Center (Infusion Therapy)
2800 W OVERLAND RD
BOISE, ID 83705
Ada County (208) 801-1414
ASHLEY GUIER DNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2800 W OVERLAND RD
BOISE, ID 83705
Ada County (986) 202-0263
CHRISTA MARIE WHALEN FNP-BC
Nurse Practitioner (Family)
2800 W OVERLAND RD
BOISE, ID 83705
Ada County (208) 810-8615
HEALING HOUSE PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
2800 W OVERLAND RD
BOISE, ID 83705
Ada County (208) 801-1414

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 Mary Derlacki's NPI number?

The NPI number for Mary Derlacki is 1609947431. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Where is Mary Derlacki located?

Mary Derlacki practices at 2800 W Overland Rd, Boise, ID 83705. The listed phone number is (208) 801-1414.

What is Mary Derlacki's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Mary Derlacki enrolled in Medicare?

Yes. Mary Derlacki is registered in the Medicare PECOS enrollment system.

What insurance does Mary Derlacki accept?

Health plans from PacificSource Health Plans list Mary Derlacki 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 Mary Derlacki was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.