NPI age
6 years
Enumerated 2019-05-26
● Active Type 2 · Organization
St Michael Nephrology, Pllc
St Michael Nephrology, Pllc is 1 of 46 internal medicine organizations in Idaho.
Primary specialty
Internal Medicine
Practice locations
2
1 secondary on file
Status
Active
No deactivations on record
Authorized official
Dytiapco
Nephrologist
Last NPPES update
2019-07-14
Source: monthly bulk 2026-05
How this organization compares
Across 46 active internal medicine providers in Idaho.
NPI age
6 years
↓ 13 yr below median
Practice locations
2
1 secondary on file
Subspecialties
0
NPI lifetime · 2019 → 2026
2019-05Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
1674 S Loggers Pond Pl Apt 14
Boise, ID 837067517
Mailing address
999 W Main St Ste 100
Boise, ID 837029001
Additional practice locations
1 secondary location on file with NPPES.
Location 2
190 E Bannock St
Boise, ID 83712
Authorized official
Ernest Daniel Moreno Dytiapco, MD
Nephrologist
📞 9862008202
Specialties
-
Internal Medicine PrimaryAn internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
St Mikes Neph
-
St Mikes Neph
Practice context
Multi-site organization. 1 additional practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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