Ryan L Van De Graaff (NPI# 1619067436, PAC ID# 8527133297) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1619067436 |
| PAC ID by PECOS | 8527133297 |
| Professional Enrollment ID | I20080814000156 |
| Full Name | Ryan L Van De Graaff |
| Organization Legal Name | SOUTHWEST IDAHO EAR NOSE AND THROAT |
| Address |
900 N Liberty St Suite 400 Boise ID 83704-8707 |
| Phone Number | 2083673320 |
| Gender | M |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 0042402034 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130007 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER |
| 130071 | ST LUKE'S NAMPA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 900 N Liberty St, Suite 400, Boise, ID 83704-8707 | 2083673320 | SOUTHWEST IDAHO EAR NOSE AND THROAT |
| Organization Legal Name | SOUTHWEST IDAHO EAR NOSE AND THROAT |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas Franklin Douthit | Physician Assistant | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Lindsay M Walles | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Eric T Garner | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Todd J Rustad | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Spencer L Cheshire | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 4424 E Flamingo Ave, Suite 320, Nampa, ID 83687-9306 |
| Shalise Adams | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 4424 E Flamingo Ave, Suite 320, Nampa, ID 83687-9306 |
| Arthur C Jones Iii | Otolaryngology | Southwest Idaho Ear Nose and Throat | 4424 E Flamingo Ave, Suite 320, Nampa, ID 83687-9306 |
| Adam Reyes | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Peter J Killian | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Matthew B Schwarz | Otolaryngology | Southwest Idaho Ear Nose and Throat | 4424 E Flamingo Ave, Suite 320, Nampa, ID 83687-9306 |
| Street Address |
900 N LIBERTY ST SUITE 400 |
| City | BOISE |
| State | ID |
| Zip | 83704-8707 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas Franklin Douthit | Physician Assistant | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Julie A Foote | Endocrinology | Treasure Valley Endocrinology PC | 900 N Liberty St, Suite 201, Boise, ID 83704-8707 |
| Lindsay M Walles | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Eric T Garner | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Todd J Rustad | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| James J Owen | Podiatry | Treasure Valley Podiatry Inc | 900 N Liberty St, Suite 306, Boise, ID 83704-8729 |
| Adam Reyes | Qualified Audiologist | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Tiffany C Heidt | Nurse Practitioner | Treasure Valley Endocrinology PC | 900 N Liberty St, Suite 201, Boise, ID 83704-8707 |
| Peter J Killian | Otolaryngology | Southwest Idaho Ear Nose and Throat | 900 N Liberty St, Suite 400, Boise, ID 83704-8707 |
| Dana S Owen | Podiatry | Treasure Valley Podiatry Inc | 900 N Liberty St, Suite 306, Boise, ID 83704-8729 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tobin E Hill | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Adrian J Curnow | Pediatric Medicine | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Julia K Bouchard | Obstetrics/gynecology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Steven J Fonken | Interventional Cardiology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, Boise, ID 83704-0107 |
| Ellis J Salloum | Vascular Surgery | Saint Alphonsus Regional Medical Center Inc | 6140 W Curtisian Ave, Boise, ID 83704-0109 |
| Samantha J Benfield | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 102 Samg Cardiothoracic Services Boise, Boise, ID 83704-0109 |
| Calvin T Jewell | General Surgery | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 100 Samg General Surgery Suite 100, Boise, ID 83704-0109 |
| Noah Blue Edvalson | Chiropractic | 3224 N Maple Grove Rd, Boise, ID 83704-4214 | |
| Christopher A Waters | Clinical Psychologist | Living Hope Clinic Inc | 3308 N Cole Rd A, Boise, ID 83704-4407 |
| Charles M Rice | Psychologist, Clinical | 3308 N Cole Rd, Suite A, Boise, ID 83704-4407 | |
| Find all physicians in zip 83704 | |||
| City | BOISE |
| Zip Code | 83704 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | BOISE + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Ryan L Van De Graaff.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.