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BENJAMIN WALKER PENNOCK
NPI 1720874555
Psychiatry & Neurology - Psychiatry in Boise, ID

Active since April 17, 2025PECOS Enrolled
500 W FORT ST, BOISE, ID 83702(208) 422-1000 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Benjamin Walker Pennock NPPES

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

BENJAMIN WALKER PENNOCK (NPI 1720874555) is an individual psychiatry provider in Boise, Idaho, licensed in Idaho (3071063) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720874555
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameBENJAMIN WALKER PENNOCK
Location Address500 W FORT STBoise, ID 83702-4501
Mailing Address500 W Fort StBoise, ID 83702-4501
Phone(208) 422-1000
Sole ProprietorNo
Enumeration DateApril 17, 2025
Last NPPES UpdateMay 15, 2025
NPPES CertifiedMay 15, 2025
✔ NPI 1720874555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in ID · 3071063
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
500 W FORT ST, Boise, ID 83702
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Benjamin Walker Pennock 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 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.

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 20

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

JESSICA ANN BERNOTSKI RDH
Dental Hygienist
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
ROBERT FISHER
Registered Nurse (Gastroenterology)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1092
LUKE DANIEL HANSEN MD
Psychiatry & Neurology (Psychiatry)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
CHRISTOPHER M GUTIERREZ
Registered Nurse (Gastroenterology)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
DR. MICHAEL GLOVER M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
500 W FORT ST, MAIL CODE #112
BOISE, ID 83702
Ada County (208) 422-1000
DR. ANN DECKER TROTTER PHD
Psychologist (Clinical)
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
REBECCA COTTERELL RN-BC, BSN
Registered Nurse
500 W FORT ST
BOISE, ID 83702
Ada County (208) 422-1000
PHILIP RESIN ELACKATT RN
Registered Nurse (Pain Management)
500 W FORT ST
BOISE, ID 83702
Ada County (986) 256-1766

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 Benjamin Pennock's NPI number?

The NPI number for Benjamin Pennock is 1720874555. It was assigned to this individual provider in the NPPES registry on April 17, 2025.

Where is Benjamin Pennock located?

Benjamin Pennock practices at 500 W Fort St, Boise, ID 83702. The listed phone number is (208) 422-1000.

What is Benjamin Pennock's specialty?

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

Is Benjamin Pennock enrolled in Medicare?

Yes. Benjamin Pennock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Benjamin Pennock was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.