Heiko Weert De Riese, MD | |
403 S 11th St Ste 210, Boise, ID 83702-6968 | |
(208) 381-6005 | |
(208) 381-6006 |
Full Name | Heiko Weert De Riese |
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Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 403 S 11th St Ste 210, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1831621333 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | M-16773 (Idaho) | Primary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 10964340-1205 (Utah) | Secondary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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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 |
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Heiko Weert De Riese, MD 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Heiko Weert De Riese, MD 403 S 11th St Ste 210, Boise, ID 83702-6968 Ph: (208) 381-6005 |
Dr. Michael E. Estess, M. D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1471 Shoreline Dr, Suite 119, Boise, ID 83702 Phone: 208-345-2630 Fax: 208-345-6504 | |
John Carr, PMHNP Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1000 N Curtis Rd Ste 202, Boise, ID 83706 Phone: 208-283-7314 | |
Eric A Simmons, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 335 Allumbaugh St, Boise, ID 83704 Phone: 208-376-1611 Fax: 208-658-1753 | |
Dr. Gary Falk, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 500 W Fort St, Boise Vamc, Boise, ID 83702 Phone: 208-422-1108 | |
Karen Porth, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1072 N Liberty Street, Ste 303, Boise, ID 83704 Phone: 208-367-2800 Fax: 208-367-7111 | |
Ramon R Quijano, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 444 W Fort St., Fl 2, Boise, ID 83702 Phone: 208-422-1018 | |
Xavier Al-mateen, Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 6348 W Emerald St, Boise, ID 83704 Phone: 208-302-0900 Fax: 208-302-0955 |