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NPI 1063660645
● Active Type 2 · Organization
St Lukes Regional Medical Center
Family Medicine · Boise, ID · NPI 1063660645
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Enumerated 2008 · 17 years on NPI
St Lukes Regional Medical Center is 1 of 1691 family medicine organizations in Idaho.
NPI age
17 years
Enumerated 2008-09-08
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Stevenson
Manager
Last NPPES update
2008-09-08
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
17 years
≈ at median (17 yr)
Practice locations
1
0 secondary on file
NPI lifetime · 2008 → 2026
2008-09 Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
3301 N Sawgrass Way
Boise, ID 837044493
📞 2083750862
Mailing address
3301 N Sawgrass Way
Boise, ID 837044493
📞 2083750862
Authorized official
Sandy Stevenson
Manager
📞 2083750862
Individual providers at this organization
14 individual providers on file at this primary practice address.
Michele Birch , DNP, FNP-C
Nurse Practitioner
NPI 1134608177
Kirsten Deutsch , MD
Family Medicine
NPI 1407800865
Mark Johnson , MD
Family Medicine
NPI 1831155365
Victoria Kincaid , MD
Family Medicine
NPI 1881259240
Russell Kocemba , MD
Family Medicine
NPI 1588629406
Becky Kroll , M.D.
Family Medicine
NPI 1457648230
Eric Maier , MD
Family Medicine
NPI 1831154707
Michael Maier , MD
Family Medicine
NPI 1912963828
Abdullahi Mohamed , MBBS
Internal Medicine
NPI 1902368970
Carson Mondada , PA-C
Physician Assistant
NPI 1558951764
Gertjan Mulder , MD
Family Medicine
NPI 1659336691
Thomas North
Family Medicine
NPI 1932762275
Zachary Stroud , PHARMD
Pharmacist
NPI 1992484067
Kelsey Wertzler , MD
Family Medicine
NPI 1659782829
Specialties
Family Medicine
Primary
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
ID license #03 taxonomy 207Q00000X
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
14 individual providers on file at this primary address.
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How to verify this organization
Confirm the NPI on NPPES. The CMS registry is the system of record. Open NPPES →
Verify the organization is in good standing. Cross-check with the state's business registration and any applicable licensing boards.
Confirm payer enrollment if billing. NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.
Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.