MARCOS DACCARETT (NPI# 1023144300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023144300 |
| Entity Type | Individual |
| Full Name | MARCOS DACCARETT |
| Credential | MD |
| Practice Address |
300 E Jefferson St Ste 101 Boise ID 83712-6246 |
| Mailing Address |
190 E Bannock St Boise ID 83712 |
| Practice Telephone | 2083364141 |
| Mailing Telephone | 2083812222 |
| Mailing Fax Number | 2083812222 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2017-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
M11330 | ID | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
M-11330 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
300 E JEFFERSON ST STE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134199631 | Cherish L Smith | Physician Assistant | 300 E Jefferson St, Suite 300, Boise, ID 83712-6246 | 2006-01-25 |
| 1962958892 | Brittany Matthews | Nurse Practitioner | 300 E Jefferson St, #300, Boise, ID 83712-6246 | 2016-08-31 |
| 1013396266 | Emily Barnett | Social Worker | 300 E Jefferson St, Boise, ID 83712-6246 | 2015-05-20 |
| 1437583408 | Andrea L Bockenstette | Nurse Practitioner | 300 E Jefferson St, Ste 101, Boise, ID 83712-6246 | 2013-08-27 |
| 1639519853 | Sara M O'connor | Nurse Practitioner | 300 E Jefferson St, Suite 101, Boise, ID 83712-6246 | 2013-07-02 |
| 1295027688 | Jodie L. Donovan | Internal Medicine | 300 E Jefferson St, Suite 300, Boise, ID 83712-6246 | 2011-05-04 |
| 1396071056 | Sorcha M Cusack | Physician Assistant | 300 E Jefferson St, Ste 300, Boise, ID 83712-6246 | 2009-10-29 |
| 1255574109 | Roger Thomas Turcotte Jr. | Internal Medicine | 300 E Jefferson St, Suite 201, Boise, ID 83712-6246 | 2009-04-08 |
| 1306006929 | Shannon R Vaughn | Nurse Practitioner | 300 E Jefferson St, Suite 101, Boise, ID 83712-6246 | 2008-06-17 |
| 1396916417 | St. Luke's Regional Medical Center | Nurse Practitioner | 300 E Jefferson St, Suite 101, Boise, ID 83712-6246 | 2008-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629405857 | Western Pacemaker Clinic, Pllc | Internal Medicine | 13960 W Wainwright Dr, Boise, ID 83713-1969 | 2013-10-02 |
| 1679733414 | Joshua I Mozes | Internal Medicine | 287 W Jefferson St, Boise, ID 83702-6045 | 2008-06-16 |
| 1669409785 | Melinda L. Marks | Internal Medicine | 300 E Jefferson St, Ste 101, Boise, ID 83712-6246 | 2006-06-26 |
| 1720033459 | Walter L Seale | Internal Medicine | 6140 W Curtisian, Ste 200, Boise, ID 83704 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190215 | Cardiovascular Specialists of America, LLC | Internal Medicine | 1515 E Clark St, Pocatello, ID 83201-4133 | 2020-10-08 |
| 1760928865 | University of Utah Pediatric Services | Internal Medicine | 110 Vista Dr, Pocatello, ID 83201-5824 | 2017-01-12 |
| 1144608308 | University of Utah Adult Services | Internal Medicine | 2985 Cortez Ave, Idaho Falls, ID 83404-7554 | 2015-05-08 |
| 1316325574 | University of Utah Adult Services | Internal Medicine | 2001 S Woodruff Ave Ste 3, Idaho Falls, ID 83404-6371 | 2015-05-08 |
| 1992182547 | University of Utah Adult Services | Internal Medicine | 3100 Channing Way, Ste 600, Idaho Falls, ID 83404-7533 | 2015-05-04 |
| 1124236393 | Alejandro Perez-verdia | Internal Medicine | 3242 S Woodruff Ave, Idaho Falls, ID 83404-8305 | 2007-05-19 |
| 1013961242 | Karl P Undesser | Internal Medicine | 745 S Progress Ave, Meridian, ID 83642-5619 | 2006-05-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.