KYLE RANDALL PETERMAN FNP
NPI 1639879596
Nurse Practitioner - Family in Boise, ID
About Kyle Randall Peterman Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KYLE RANDALL PETERMAN FNP (NPI 1639879596) is an individual family provider in Boise, Idaho, licensed in Idaho (57854) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kyle Randall Peterman Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BOISE, ID 83702
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 Kyle Peterman's NPI number?
The NPI number for Kyle Peterman is 1639879596. It was assigned to this individual provider in the NPPES registry on March 8, 2023.
Where is Kyle Peterman located?
Kyle Peterman practices at 500 W Fort St, Boise, ID 83702. The listed phone number is (208) 422-1000.
What is Kyle Peterman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kyle Peterman enrolled in Medicare?
Yes. Kyle Peterman is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kyle Peterman was last updated on July 25, 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.
# Kyle Randall Peterman, FNP · NPI 1639879596
Family physician in Boise, Idaho. Individual provider, active in the CMS NPPES registry since March 8, 2023.
## Identity
- **NPI:** 1639879596 (Entity type: Individual)
- **Enumerated:** March 8, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 57854 (Idaho)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 500 W FORT ST, Boise, ID 83702-4501
- **Phone:** (208) 422-1000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 25, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1639879596) · Data from the CMS NPPES public registry.