EVAN MELVILLE DO
NPI 1942867148
Pediatrics - Sports Medicine in Boise, ID

Q: What is Evan Melville's NPI number?

The NPI number for Evan Melville is 1942867148. It was assigned to this individual provider in the NPPES registry on May 22, 2019.

Q: What is Evan Melville's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Q: When was this NPI record last updated?

The NPPES record for Evan Melville was last updated on December 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since May 22, 2019PECOS EnrolledAccepts Medicare Assignment

2619 W FAIRVIEW AVE, BOISE, ID 83702(208) 706-9311(208) 489-4300 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 5, 2025, May 22, 2019 (2 updates tracked since 2019).

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About Evan Melville Do NPPES

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

EVAN MELVILLE DO (NPI 1942867148) is an individual sports medicine provider in Boise, Idaho, licensed in Idaho (O-1882) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1942867148

Entity TypeIndividualMale

Primary Taxonomy2080S0010X

Provider Legal NameEVAN MELVILLECredential: DO

Location Address2619 W FAIRVIEW AVEBoise, ID 83702-6722

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 706-9311

Fax(208) 489-4300

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 22, 2019

Last NPPES UpdateDecember 5, 20252 updates tracked since enumeration

NPPES CertifiedDecember 5, 2025

✔ NPI 1942867148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080S0010X

License✔ Licensed in ID · O-1882

Definition

A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

2619 W FAIRVIEW AVE, Boise, ID 83702

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Evan Melville Do 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 ID5698122299

PECOS Enrollment IDI20231102003982

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

95 services90 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

76 services76 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

55 services53 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

51 services51 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

44 services43 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

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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.

JENNIFER LYNN RICE LAT, ATC

Specialist/Technologist (Athletic Trainer)