Dr Richard C Ballantyne, DO | |
215 E Hawaii Ave, Nampa, ID 83686-6011 | |
(208) 364-3000 | |
Not Available |
Full Name | Dr Richard C Ballantyne |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 21 Years |
Location | 215 E Hawaii Ave, Nampa, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174745582 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | IA-3634 (Iowa) | Secondary |
208600000X | Surgery | IA-3634 (Iowa) | Secondary |
208600000X | Surgery | O0485 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Luke's Nampa Medical Center | Nampa, ID | Hospital |
St Luke's Regional Medical Center | Boise, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Lukes Clinic-treasure Valley Llc | 4981878402 | 991 |
Entity Name | St Lukes Clinic-treasure Valley Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard C Ballantyne, DO 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 381-2222 | Dr Richard C Ballantyne, DO 215 E Hawaii Ave, Nampa, ID 83686-6011 Ph: (208) 364-3000 |
Matthew J. Wood, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1512 12th Ave Rd, Nampa, ID 83686 Phone: 208-463-5029 | |
Ronald William Cornwell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 4400 E Flamingo Ave, Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Dennis Weiler, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3918 Chicago St, Nampa, ID 83686 Phone: 208-467-5155 | |
Dr. Forrest R Fredline, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Christian P Vetsch, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-463-3141 Fax: 208-463-3044 | |
Richard J Martin, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo, Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Katherine Homer, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 |