MARIO BRUS (NPI# 1790786515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790786515 |
| Entity Type | Individual |
| Full Name | MARIO BRUS |
| Credential | MD |
| Practice Address |
1150 N Sister Catherine Way Nampa ID 83687 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2083027000 |
| Practice Fax Number | 2083027055 |
| Mailing Telephone | (208) 302-7000 |
| Mailing Fax Number | 2083027055 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | M-13125 | ID | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 200901147 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003607400 | 05 |
| Street Address |
1150 N SISTER CATHERINE WAY |
| City | NAMPA |
| State | ID |
| Zip Code | 83687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033686076 | Nadezhda Kravchuk | Nurse Practitioner | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2018-10-29 |
| 1144738717 | Justin Willis Devinaspre | Nurse Practitioner | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2018-01-17 |
| 1821458241 | Danae Elizabeth Perkins | Physician Assistant | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2016-02-26 |
| 1548644099 | Amanda Dozier | Nurse Practitioner | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2015-07-15 |
| 1790105518 | Kristen Young | Family Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2014-04-19 |
| 1285077701 | Ryan G Townsend | Internal Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687-3133 | 2013-04-15 |
| 1427314475 | Katherine Latham Ball | Family Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2012-04-04 |
| 1629354121 | Jami Lea Hoke | Physician Assistant | 1150 N Sister Catherine Way, Nampa, ID 83687-3133 | 2011-10-27 |
| 1265693386 | Bridgette M Baker | Family Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2008-06-20 |
| 1629107131 | Howard W Shoemaker | Preventive Medicine | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2007-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307447 | Current Physical Therapy Nampa LLC | Physical Therapist | 16150 N High Desert Street, Nampa, ID 83687 | 2020-02-10 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1750828513 | Daniel & Max, LLC | Optometrist | 1600 Karcher Rd, Nampa, ID 83687 | 2017-01-31 |
| 1578965422 | Jorge Domingo Reyes | Counselor | 5700 E. Franklin Rd., Suite 220-i, Nampa, ID 83687 | 2014-09-23 |
| 1619302080 | David Lyle Farris | Dentist | 16548 North Franklin Blvd., Nampa, ID 83687 | 2013-09-04 |
| 1871934547 | Ian Zafar Qureshi | Internal Medicine | 4400 E Flamingo Ave Ste 130, Nampa, ID 83687 | 2013-07-10 |
| 1457696783 | Laurel Evans | Specialist/Technologist | 850 W. St. Luke's Dr., Suite 215, Nampa, ID 83687 | 2012-11-27 |
| 1750641197 | Andrea Patricia Fitzer | Nurse Practitioner | 4400 E. Flamingo Ave, Nampa, ID 83687 | 2012-05-18 |
| 1679846182 | Ivony Case Management | Case Management | 811 12th Street, Ste. 2, Nampa, ID 83687 | 2012-02-14 |
| 1699043679 | Saltzer Medical Group, P.a. | Durable Medical Equipment & Medical Supplies | 9850 W St Lukes Drive, Nampa, ID 83687 | 2011-12-06 |
| Find all providers in zip 83687 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053301911 | Thomas J Hammer | Pediatrics | 1209 N Jacob Allcott Way, Nampa, ID 83687 | 2005-10-24 |
| 1285925644 | Amanda King Mason | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686 | 2011-04-20 |
| 1831304526 | Preston S Omer | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2007-05-14 |
| 1386744910 | Alicia Mary Suski | Pediatrics | 207 1st St S, Nampa, ID 83651-3703 | 2006-09-24 |
| 1386616431 | Michael B Aldous | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2006-02-03 |
| 1154311892 | Joseph L Papiez | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-25 |
| 1932198967 | Richard Aguilar | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-21 |
| 1154311199 | Jeannette E Jain | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-21 |
| 1639169626 | Deanna M Andrews | Pediatrics | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-10-21 |
| 1871588632 | Michael J Wheaton | Pediatrics | 1150 N Sister Catherine Way, Nampa, ID 83687 | 2005-09-16 |
| Find all providers in NAMPA | ||||
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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.