Northside Chiropractic is a medicare enrolled "Clinic/center - Health Service" provider in Boise, Idaho. Their current practice location is
2301 N 36th St, Boise, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 571-8418.
Northside Chiropractic is licensed to practice in Idaho (license number CHIA-1056) and it also participates in the medicare program. Northside Chiropractic
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1689709735.
Healthcare Provider's Profile
| Full Name | Northside Chiropractic |
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| Type | Facility |
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| Speciality | Clinic/center - Health Service |
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| Location | 2301 N 36th St, Boise, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689709735
- Provider Enumeration Date: 02/22/2007
- Last Update Date: 02/04/2008
Medicare PECOS Information:
- PECOS PAC ID: 4082797766
- Enrollment ID: O20080219000417
Medical Identifiers
Medical identifiers for Northside Chiropractic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689709735 | NPI | - | NPPES |
| 1497750350 | Other | WA | NPI-INDIVIDUAL |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 3119 (Washington) | Secondary |
| 261QH0100X | Clinic/center - Health Service | CHIA-1056 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Northside Chiropractic acts as a billing entity for following providers:
| Provider Name | Mick Tiegs |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1497750350
PECOS PAC ID: 6901989680
Enrollment ID: I20080219000412 |
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| Provider Name | Rian Torres |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1407900327
PECOS PAC ID: 2860525185
Enrollment ID: I20100805001165 |
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| Provider Name | William K Davis |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1144398389
PECOS PAC ID: 3577789320
Enrollment ID: I20140731000064 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Northside Chiropractic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Northside Chiropractic
2301 N 36th St,
Boise, ID 83703-5207
Ph: (208) 571-8418 | Northside Chiropractic
2301 N 36th St,
Boise, ID 83703-5207
Ph: (208) 571-8418 |
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