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NPI 1548890460
● Active Type 2 · Organization
Mmmedical Group Llc.
Nurse Practitioner · Boise, ID · NPI 1548890460
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Enumerated 2020 · 6 years on NPI
Mmmedical Group Llc. is 1 of 658 nurse practitioner organizations in Idaho.
NPI age
6 years
Enumerated 2020-01-20
Primary specialty
Nurse Practitioner
Practice locations
2
1 secondary on file
Status
Active
No deactivations on record
Authorized official
Evaro
President
Last NPPES update
2020-09-23
Source: monthly bulk 2026-05
How this organization compares
Across 658 active nurse practitioner providers in Idaho.
NPI age
6 years
↓ 2 yr below median
Practice locations
2
1 secondary on file
NPI lifetime · 2020 → 2026
2020-01 Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
801 N Stilson Rd Ste 300
Boise, ID 837035145
📞 2083324540
Mailing address
Po Box 5328
Boise, ID 837050328
📞 2083330000
Additional practice locations
1 secondary location on file with NPPES.
Location 2
9858 W State St
Star, ID 836695210
📞 2082869471 fax 8339180940
Authorized official
Randy Evaro
President
📞 2083330000
Individual providers at this organization
1 individual provider on file at this primary practice address.
Specialties
Nurse Practitioner
Primary
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
taxonomy 363L00000X
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
Plus 1 secondary practice location.
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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.