OrganizationActive
Integrated Dermatology of Boise, LLC
NPI 1528704863 · Dermatology Physician · Meridian, ID
Provider details
- NPI number
- 1528704863
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Ellen Luchetti, Authorized Group Official(208) 900-3376
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
3277 E Louise Dr Ste 360
Meridian, ID 83642-9359
Phone: (208) 900-3376
Fax: (986) 210-1370
Street-level locationGet directions
Mailing address
4700 Exchange Ct Ste 110
Boca Raton, FL 33431-4450
Registry dates
- Enumerated
- 2022-05-10
- Last updated
- 2022-12-05
- Certified
- 2022-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.