Boise Shoulder Clinic, PA
NPI 1760581409ActiveOrganization· Orthopaedic Surgery· Eagle, ID
Orthopaedic Surgery in Eagle, Idaho, registered in NPPES in September 2006. The authorized official on file is Carl Scott Humphrey, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1760581409 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 21, 2006 |
| Last updated in NPPES | Feb 13, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery Primary | 207X00000X | M9563 | 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) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other orthopedic surgeons in Eagle
- 1811978778
- 1629074158
- 1821910472
- 1558310318