BOISE RADIOLOGY GROUP PLLC
NPI 1740216175
Radiology - Diagnostic Radiology in Boise, ID

Q: What is Boise Radiology Group PLLC's NPI number?

The NPI number for Boise Radiology Group PLLC is 1740216175. It was assigned to this organization in the NPPES registry on June 25, 2006.

Q: What is Boise Radiology Group PLLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Active since June 25, 2006

620 W HAYS ST, BOISE, ID 83702(208) 381-2094(208) 381-1791 Get Directions Write a Review

NPPES record last updated: March 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 4, 2024, Aug 30, 2016 (2 updates tracked since 2016).

On this page

About Boise Radiology Group Pllc NPPES

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

BOISE RADIOLOGY GROUP PLLC (NPI 1740216175) is a healthcare organization registered as a diagnostic radiology in Boise, Idaho and active in the NPI registry since June 2006. The organization lists Lisa Smith, Administrator, as its authorized official.

NPPES Registry Identity

NPI1740216175

Entity TypeOrganization

Primary Taxonomy2085R0202X

Legal Business NameBOISE RADIOLOGY GROUP PLLC

Location Address620 W HAYS STBoise, ID 83702-5511

Mailing AddressPo Box 1616Evansville, IN 47706-0018 · (208) 381-2094 · Fax (208) 381-1791

Phone(208) 381-2094

Fax(208) 381-1791

Organization SubpartNo

Authorized OfficialLisa SmithAdministrator · (208) 433-9466

Enumeration DateJune 25, 2006

Last NPPES UpdateMarch 4, 20242 updates tracked since enumeration

NPPES CertifiedMarch 4, 2024

✔ NPI 1740216175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedRadiology · NeuroradiologyTaxonomy 2085N0700X

Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X

620 W HAYS ST, Boise, ID 83702

Open in Google Maps ↗

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..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)

Boise Radiology Group Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 65 clinicians reassign Medicare billing to Boise Radiology Group PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 36 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Diagnostic Radiology63

Interventional Radiology2

Nearest to this location (20)

See all 65

Carl Odom, MD

Diagnostic Radiology

NPI 1740523513

620 W HAYS ST
Boise, ID 83702

(208) 381-2094

✔ PECOS✔ Accepts MedicareSame address

Blake Niederhauser, MD

Diagnostic Radiology

NPI 1578726683

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Brian Mcmahan, M.D.

Diagnostic Radiology

NPI 1043501273

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Shane Ball, M.D.

Diagnostic Radiology

NPI 1679500557

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Cody Boyce, M.D.

Diagnostic Radiology

NPI 1508816471

190 E BANNOCK
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Sean Carr, M.D.

Diagnostic Radiology

NPI 1851335509

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Michael Carroll, M.D.

Diagnostic Radiology

NPI 1639306566

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Stephanie Cheng, MD

Diagnostic Radiology

NPI 1356665285

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Elaine Daniel, M.D.

Diagnostic Radiology

NPI 1720024094

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Geoffry De Gennaro, M.D.

Diagnostic Radiology

NPI 1336554740

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Quinn Demordaunt, M.D.

Diagnostic Radiology

NPI 1750323226

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Daniel Dickman, D.O.

Diagnostic Radiology

NPI 1902256548

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2809

✔ PECOS✔ Accepts Medicare0.6 mi

Michael Fisher, M.D.

Diagnostic Radiology

NPI 1134155229

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Michael Fuchs, M.D.

Diagnostic Radiology

NPI 1588692289

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Tyler Gasser, M.D.

Diagnostic Radiology

NPI 1427202373

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Tyler Harris, MD

Diagnostic Radiology

NPI 1275794935

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

James Hill, MD

Diagnostic Radiology

NPI 1326156282

190 E BANNOCK
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Christopher Jennings, M.D.

Diagnostic Radiology

NPI 1679517320

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS0.6 mi

Andrew Peterson, M.D.

Interventional Radiology

NPI 1083842033

190 E BANNOCK ST
Boise, ID 83712

(208) 381-2094

✔ PECOS✔ Accepts Medicare0.6 mi

Whitney Shofner Michalsky, M.D

Interventional Radiology

NPI 1548502446

190 E BANNOCK ST
Boise, ID 83712

(206) 386-2123

✔ PECOS✔ Accepts Medicare0.6 mi

See all 65 clinicians

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 Boise Radiology Group PLLC's NPI number?

The NPI number for Boise Radiology Group PLLC is 1740216175. It was assigned to this organization in the NPPES registry on June 25, 2006.

Where is Boise Radiology Group PLLC located?

Boise Radiology Group PLLC is located at 620 W Hays St, Boise, ID 83702. The listed phone number is (208) 381-2094.

What is Boise Radiology Group PLLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Boise Radiology Group PLLC enrolled in Medicare?

Yes. Boise Radiology Group PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Boise Radiology Group PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 65 clinicians in 2 Medicare specialties reassign their Medicare billing to Boise Radiology Group PLLC. 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 Diagnostic Radiology (63) and Interventional Radiology (2). Of these, 1 practice at this address and 36 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Boise Radiology Group PLLC accept?

Health plans from Moda Health Plan, Inc. list Boise Radiology Group PLLC 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 Boise Radiology Group PLLC was last updated on March 4, 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.