Mmmedical Group LLC.
NPI 1548890460ActiveOrganization· Nurse Practitioner· Boise, ID
Nurse Practitioner in Boise, Idaho, registered in NPPES in January 2020. The authorized official on file is Randy Evaro, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1548890460 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 20, 2020 |
| Last updated in NPPES | Sep 23, 2020 |
| Certified by provider | Sep 23, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other Nurse Practitioner providers in Boise
- 1972962181
- 1568589596
- 1245613967
- 1487307468
- 1184491755
- 1205093739
- 1639779713
- 1932982428
- 1922125764
- 1124677141
- 1083815294
- 1063786648