Boise Skin Clinic PLLC
NPI 1104220797 · Dermatology Physician · Boise, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Boise Skin Clinic PLLC is a Dermatology Physician organization in Boise, ID (NPI 1104220797).
Provider details
- NPI number
- 1104220797
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Marnie Ririe, Manager(208) 258-2078
- License
- M-9342 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-10-10
- Last updated
- 2019-01-22
Frequently asked questions
- What is Boise Skin Clinic PLLC's NPI number?
- Boise Skin Clinic PLLC's National Provider Identifier (NPI) is 1104220797, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Boise Skin Clinic PLLC?
- Boise Skin Clinic PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Boise Skin Clinic PLLC located?
- Boise Skin Clinic PLLC's practice location on file with NPPES is 1636 S Hadley Ave, Boise, ID 83709-2684.
- What is Boise Skin Clinic PLLC's phone number?
- The practice phone number listed in the NPPES registry for Boise Skin Clinic PLLC is (208) 209-7898.
- Does Boise Skin Clinic PLLC accept Medicare?
- Boise Skin Clinic PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Boise Skin Clinic PLLC?
- The authorized official listed on Boise Skin Clinic PLLC's NPPES record is Marnie Ririe, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Boise Skin Clinic PLLC's NPI active?
- Yes — Boise Skin Clinic PLLC's NPI (1104220797) is active in the NPPES registry as of the last update on 2019-01-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.