KENNETH EDWARD SQUIRES III D.O.
NPI 1649706326
Psychiatry & Neurology - Psychiatry in Boise, ID

Q: What is Kenneth Squires's NPI number?

The NPI number for Kenneth Squires is 1649706326. It was assigned to this individual provider in the NPPES registry on May 2, 2017. The provider is also known as Kenny Squires D.O..

Q: What is Kenneth Squires's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Squires was last updated on May 15, 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.

Active since May 02, 2017PECOS EnrolledAccepts Medicare Assignment

6348 W EMERALD ST, BOISE, ID 83704(208) 302-0900(208) 302-0955 Get Directions Write a Review

NPPES record last updated: May 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Kenneth Edward Squires Iii D.o. NPPES

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

KENNETH EDWARD SQUIRES III D.O. (NPI 1649706326) is an individual psychiatry provider in Boise, Idaho, licensed in Idaho (O-1978) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Corvallis, and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2017).

NPPES Registry Identity

NPI1649706326

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameKENNETH EDWARD SQUIRES IIICredential: D.O.

Location Address6348 W EMERALD STBoise, ID 83704-8732

Mailing AddressPo Box 190930Boise, ID 83719-0930 · (208) 367-5170 · Fax (208) 367-5180

Phone(208) 302-0900

Fax(208) 302-0955

Sole ProprietorNo

Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2017

Enumeration DateMay 2, 2017

Last NPPES UpdateMay 15, 2024

NPPES CertifiedMay 15, 2024

✔ NPI 1649706326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in ID · O-1978✔ Licensed in OR · PG183059

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

6348 W EMERALD ST, Boise, ID 83704

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Other Names 1

Other Name (5)Kenny Squires D.o.

Secondary Practice Location 1

Location 13600 NW Samaritan DrCorvallis, OR 97330-3737 · Phone (541) 768-4906

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Edward Squires Iii D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446529242

PECOS Enrollment IDI20240530001672

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.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Squires reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Alphonsus Regional Medical Center Inc

0.2 mi

Psychologist

1055 N CURTIS RD
Boise, ID 83706

Reassigned Medicare billing, Idaho enrollment
781 clinicians in this Medicare group

NPI 1649357716 (208) 367-4148

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83704 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

$160.17 typical visit price

range $52.44 – $160.17

Typical copayment $40.04 (range $13.11 – $40.04)

Most-billed visit code 99205

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

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 13

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

XAVIER AL-MATEEN

Student in an Organized Health Care Education/Training Program