Kenneth M Little, MD | |
190 E Bannock St, 10th Floor, Boise, ID 83712-6241 | |
(208) 381-5500 | |
(208) 381-2555 |
Full Name | Kenneth M Little |
---|---|
Gender | Male |
Speciality | Neurosurgery |
Experience | 26 Years |
Location | 190 E Bannock St, Boise, 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 |
---|---|---|---|
1023039468 | NPI | - | NPPES |
000010152057 | Other | REGENCE BLUE SHIELD | |
269560 | Other | OR | OMAP |
8J190 | Other | ID | BLUE CROSS OF IDAHO GROUP |
0203233 | Other | WA | WA DEPARTMENT OF LABOR |
860902000 | Medicaid | ID | |
610978600 | Other | US DEPARTMENT OF LABOR | |
807732400 | Medicaid | ID | |
74906 | Other | ID | BLUE CROSS OF IDAHO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207T00000X | Neurological Surgery | M8861 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Luke's Regional Medical Center | Boise, ID | Hospital |
St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
St Luke's Nampa Medical Center | Nampa, ID | Hospital |
St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
Grande Ronde Hospital | La grande, OR | 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 |
---|---|
Kenneth M Little, MD 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 381-2222 | Kenneth M Little, MD 190 E Bannock St, 10th Floor, Boise, ID 83712-6241 Ph: (208) 381-5500 |
Bruce J Andersen, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1072 N Liberty St, Suite 303, Boise, ID 83704 Phone: 208-367-4035 Fax: 208-367-7111 | |
Roy Tyler Frizzell, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 222 N 2nd St, Ste 307, Boise, ID 83702 Phone: 208-344-1000 Fax: 208-344-1331 | |
Michael V Hajjar, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 6140 W Curtisian Ave Ste 400, Boise, ID 83704 Phone: 208-327-5600 Fax: 208-327-5602 | |
Michael L Henbest, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 6140 Curtisian Ave, Suite 400, Boise, ID 83704 Phone: 208-367-3500 Fax: 208-367-2968 | |
Dr. Donald John Blaskiewicz, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St Fl 10, Boise, ID 83712 Phone: 208-381-5500 | |
Phillip Clayton Berryhill, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 1075 N. Curtis Rd, Suite 201, Boise, ID 83706 Phone: 208-367-4000 Fax: 208-367-4052 |