IDAHO SPORTS MEDICINE INSTITUTE PA
IDAHO SPORTS MEDICINE INSTITUTE PA is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1154356624, based in Boise, ID. It is classified under Sports Medicine (Neuromusculoskeletal Medicine) Physician.
Getting there
The practice address on file is 1188 UNIVERSITY DR, Boise, ID 83706. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| N/A FOR GROUP | Sports Medicine (Neuromusculoskeletal… primary |
Licences are recorded in 0 states: . Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1759278765
- Enrollment ID
- O20040303001050
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Neuromusculoskeletal Medicine, Sports Medicine covers
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. NUCC Health Care Provider Taxonomy, code 204C00000X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1154356624 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jul 12, 2006 |
| Last updated | Jan 6, 2026 |
| Status | Active |
| Practice address |
1188 UNIVERSITY DR Boise, ID 83706 (208) 336-8250 Fax (208) 345-9514 |
| Mailing address |
1188 W UNIVERSITY DR Boise, ID 83706 |
| Other identifiers |
805993900
· Medicaid (ID) 8628-0 · Other (ID) Regence Blue Shield · Other (ID) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 5 | 4 | 3 | 5 | 6 | 6 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 1 | 4 | 6 | 5 | 3 | 6 | 4 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.