Idaho Diabetes and Endocrine Associates, PA
NPI 1790960961 · Endocrinology, Diabetes & Metabolism Physician · Boise, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Idaho Diabetes and Endocrine Associates, PA is a Endocrinology, Diabetes & Metabolism Physician organization in Boise, ID (NPI 1790960961).
Provider details
- NPI number
- 1790960961
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Theodore Roosevelt, President(208) 389-2213
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Specialist174400000X
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Other names (DBA / former)
- Doing business as
- Idaho Diabetes & Endocrine Associates, PA
Registry dates
- Enumerated
- 2008-01-07
- Last updated
- 2022-05-18
- Certified
- 2022-05-18
Frequently asked questions
- What is Idaho Diabetes and Endocrine Associates, PA's NPI number?
- Idaho Diabetes and Endocrine Associates, PA's National Provider Identifier (NPI) is 1790960961, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Idaho Diabetes and Endocrine Associates, PA?
- Idaho Diabetes and Endocrine Associates, PA is classified in the NPPES registry as Endocrinology, Diabetes & Metabolism Physician (Allopathic & Osteopathic Physicians).
- Where is Idaho Diabetes and Endocrine Associates, PA located?
- Idaho Diabetes and Endocrine Associates, PA's practice location on file with NPPES is 13909 W. Wainwright Drive, Boise, ID 83713-1969.
- What is Idaho Diabetes and Endocrine Associates, PA's phone number?
- The practice phone number listed in the NPPES registry for Idaho Diabetes and Endocrine Associates, PA is (208) 389-2213.
- Does Idaho Diabetes and Endocrine Associates, PA accept Medicare?
- Idaho Diabetes and Endocrine Associates, PA 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 Idaho Diabetes and Endocrine Associates, PA?
- The authorized official listed on Idaho Diabetes and Endocrine Associates, PA's NPPES record is Theodore Roosevelt, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Idaho Diabetes and Endocrine Associates, PA's NPI active?
- Yes — Idaho Diabetes and Endocrine Associates, PA's NPI (1790960961) is active in the NPPES registry as of the last update on 2022-05-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.