Mark E. Kieckbusch, M.D.
NPI 1215981410ActiveIndividual· Pathology, Anatomic Pathology & Clinical Pathology· Boise, ID
Pathology, Anatomic Pathology & Clinical Pathology (M.D.) in Boise, Idaho, licensed in ID, with an NPI issued in May 2006. Medicare paid $17,069 for services to 213 patients in 2024.
Overview
| NPI | 1215981410 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | May 20, 2006 |
| Last updated in NPPES | Dec 11, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pathology, Anatomic Pathology & Clinical Pathology Primary | 207ZP0102X | M6070 | ID |
| Pathology, Hematology | 207ZH0000X | M6070 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 213 |
|---|---|
| Services billed | 728 across 34 procedure codes |
| Paid by Medicare | $17,069 |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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