● Active Type 1 · Individual

Kenneth Madsen, MD

Surgery·Boise, ID· NPI 1164412862 · Enumerated 2005 · 20 years on NPI

Madsen is 1 of 16 surgery providers in Boise and 1 of 38 in Idaho.

NPI age

20 years

Enumerated 2005-10-24

Primary specialty

Surgery

Plus 4 subspecialties

Licensed in

ID, WY, NC, FL

4 states

Status

Active

No deactivations on record

Last NPPES update

2023-10-24

Source: monthly bulk 2026-05

Sole proprietor

May be part of a larger org

How this provider compares

Across 38 active surgery providers in Idaho.

NPI age

20 years

≈ at median (19 yr)

State licenses

4 states

Top 57% — 42% of peers are multi-state

Subspecialties

In the 55% of peers with subspecialties

NPI lifetime · 2005 → 2026

2005-10Enumerated in NPPES

2005 2026

Where they practice

Practice location

1075 N Curtis Rd Ste 101

Boise, ID 837061348

📞 2083022800fax 2083022825

Mailing address

3810 Northdale Blvd, Ste 150

Tampa, FL 336241871

Additional practice locations

1 secondary location on file with NPPES.

Location 2

208 Cox Blvd Ste 201

Goldsboro, NC 275349414

📞 9195873333fax 9195873334

Specialties

Allopathic & Osteopathic Physicians › Surgery

Surgery Primary

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

ID license #M-12372WY license #6720AFL license #ME153722 taxonomy 2086S0129X
Surgery

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and...

WY license #6720ANC license #2018-01195 taxonomy 208600000X

Identifiers

Type	Value	Notes
05 (CO)	01371657
05 (WY)	121692900

Multi-state credentialing: Licensed in 4 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.

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How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.